Automatic retractable safety penetrating instrument

ABSTRACT

An automatic retractable safety penetrating instrument for introduction of sleeves, such as portal sleeves, cannulas and catheters, into anatomical cavities by means of penetrating members, such as solid tip trocars, other solid configuration obturators and cannulated penetrating members, such as needles, include locking and releasing mechanisms for automatic retraction of the penetrating member into the sleeve upon the sleeve entering the anatomical cavity. Various locking and releasing mechanisms are utilized for disposition in the penetrating member hub, in the shaft of the penetrating member or partially in the shaft and the hub, and the penetrating member can be made of telescoping distal and shaft sections to minimize the length of the penetrating member hub.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a division of prior application Ser. No. 08/196,027,filed Feb. 14, 1994, which is a division application of priorapplication Ser. No. 07/945,177, filed Sep. 15, 1992, which is acontinuation-in-part of patent application Ser. No. 07/745,071, filedAug. 14, 1991, now abandoned Ser. No. 07/800,507, filed Nov. 27, 1991,now abandoned Ser. No. 07/805,506 now U.S. Pat. No. 5,330,432 filed Dec.6, 1991, Ser. No. 07/808,325 now U.S. Pat. No. 5,324,268, filed Dec. 16,1991, Ser. No. 07/848,838 now U.S. Pat. No. 5,445,617, filed Mar. 10,1992, Ser. No. 07/868,556 now U.S. Pat. No. 5,320,610, and Ser. No.07/868,578 now U.S. Pat. No. 5,336,176, both filed Apr. 15, 1992, andSer. No. 07/929,338 now U.S. Pat. No. 5,360,405, filed Aug. 14, 1992.The specifications of the above patent applications are incorporatedherein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention pertains to safety penetrating instruments and,more particularly, to automatic retractable safety penetratinginstruments having sleeves for introduction into anatomical cavities andpenetrating members with sharp tips disposed within the sleeves forpenetrating cavity walls with automatic retraction of the penetratingmembers into the sleeves upon penetration to protect tissue and organstructures within the cavities from the sharp tips of the penetratingmembers.

2. Discussion of the Prior Art

Penetrating instruments are widely used in medical procedures to gainaccess to anatomical cavities ranging in size from the abdomen to smallblood vessels, such as veins and arteries, epidural, plural andsubachroniad spaces, heart ventricles and spinal and synovial cavities,with access being established via a sleeve positioned during penetrationinto the cavity with the penetrating instrument. Use of penetratinginstruments has become an extremely popular and important first step inendoscopic, or least invasive, surgical procedures to establish anendoscopic portal for many various procedures with access beingestablished via portal sleeves of the penetrating instruments. Suchpenetrating instruments typically include a portal sleeve and apenetrating member disposed within the portal sleeve and having a sharptip or point to pierce or penetrate the tissue forming the cavity wallwith the force required to penetrate the cavity wall being dependentupon the type and thickness of the tissue of the wall. Once the wall ispenetrated, it is desirable to prevent the sharp tip of the penetratingmember from inadvertent contact with or injury to tissue or organstructures in or forming the cavity, and a particular problem existswhere substantial force is required to penetrate the cavity wall or thecavity is very small in that, once penetration is achieved, the lack oftissue resistance can result in the sharp tip traveling too far into thecavity and injuring adjacent tissue or organ structures.

Safety trocars having a spring-biased protective shield disposed betweenan outer sleeve and an inner trocar are marketed by Ethicon, Inc. as theEndopath and by United States Surgical Corp. as the Surgiport. U.S. Pat.No. 4,535,773 to Yoon, No. 4,601,710 to Moll and No. 4,654,030 to Mollet al are illustrative of such safety trocars. A trocar disposed withina portal sleeve and retractable within the sleeve when force from tissuecontact is removed from the sharp tip of the trocar is set forth in U.S.Pat. No. 4,535,773 to Yoon.

SUMMARY OF THE INVENTION

It is a primary object of the present invention to provide improved,simplified automatic retractable safety penetrating instruments capableof use in a wide variety of procedures.

A further object of the present invention is to provide an automaticretractable safety penetrating instrument having a locking and releasingmechanism rotatable or pivotal around an axis in parallel and spacedfrom a longitudinal axis of the automatic retractable safety penetratinginstrument for automatically releasing a retracting mechanism to permitretraction of a penetrating member upon entry of the instrument into ananatomical cavity.

An additional object of the present invention is to position a rotatablelocking and releasing mechanism within a shaft of a penetrating memberof an automatic retractable safety penetrating instrument to reduce thesize of the proximal hub or handle for the penetrating member.

A further object of the present invention is to form a penetratingmember of an automatic retractable safety penetrating instrument oftelescoping parts such that the distal end can be moved proximallyrelative to the shaft upon retraction thereby reducing the length of thehub or handle for the penetrating member.

Yet another object of the present invention is to automatically triggerretraction of a penetrating member within a sleeve upon movement of anoperating member distally of a rest position after initial movement ofthe operating member proximally of the rest position during penetrationof tissue.

A further object of the present invention is to combine triggermechanisms in an automatic retractable safety penetrating instrumentsuch that retraction can be triggered by distal movement of an operatingmember at a position rearward of a rest position of the operating memberand/or a position forward of the rest position.

Another object of the present invention is to configure a safetypenetrating instrument to allow the safety penetrating instrument tohave various optional modes of operation including retraction of thepenetrating member, retraction of the penetrating member along with asafety shield or probe, the penetrating member locked against retractionto operate as a standard penetrating instrument, the penetrating memberretracts while the safety shield or probe remains extended, or thepenetrating member locked against retraction while safety shield orprobe moves distally.

Some of the advantages of the present invention over the prior art arethat small or narrow anatomical cavities can be safety penetrated,sleeves can safely be introduced into anatomical cavities of varioussizes to expand the use of least invasive procedures in many areasincluding, for example, cardiac, brain, vascular, chest, genitourinarysystem, breast and spinal fields, safe penetration of cavities can beaccomplished with no parts of the safety penetrating instrument otherthan the sleeve protruding beyond the sharp tip of the penetratingmember as is particularly desirable where organ structures adhere tocavity walls, the automatic retractable safety penetrating instrumentencourages the use of a smooth, continuous penetration motion by thesurgeon thereby reducing trauma, tears and irregular surfaces in thetissue of the cavity wall, the automatic retractable safety penetratinginstrument can be used to penetrate anatomical cavities of the typecontaining organ structures that could be injured by contact with even ablunt instrument part such as a safety shield, the automatic retractablesafety penetrating instrument can be economically made of plastic withrelatively few components, safe penetration is achieved while permittinginjection or evacuation of fluids, a single puncture can be used forboth insufflation and forming an endoscopic portal thereby simplifyingdiagnostic and surgical procedures, trauma and damage to tissue isminimized, tissue jamming and trapping are avoided and automaticretractable safety penetrating instruments according to the presentinvention can be inexpensively manufactured to be reusable or disposablefor universal use.

These and other objects and advantages of the present invention willbecome apparent from the following description of the preferredembodiments taken in conjunction with the accompanying drawings whereinidentical reference numbers indicate identical parts or parts providingidentical functions.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a broken side view, partly in section, of an automaticretractable safety penetrating instrument according to the presentinvention in a rest state.

FIGS. 2, 3 and 4 are broken side views, partly in section of theautomatic retractable safety penetrating instrument of FIG. 1 in variousstates of operation.

FIG. 5 is a broken perspective view of an end cap release mechanism foruse with the automatic retractable safety penetrating instrument of thepresent invention.

FIG. 5A is a perspective view of an end cap release mechanism carrying alocking and releasing mechanism for use with the automatic retractablesafety penetrating instrument of the present invention.

FIG. 5B is a perspective view of an end cap release mechanism carrying amodified locking and releasing mechanism for use with the automaticretractable safety penetrating instrument of the present invention.

FIG. 5C is a section taken along lines 5C--5C of FIG. 5B with theaddition of a retraction plate and an operating member.

FIG. 5D is a broken side view, partly in section, of a modified lockingand releasing mechanism for use with the automatic retractable safetypenetrating instrument of the present invention wherein the trigger isformed by an angled flat spring member.

FIG. 6 is a broken side view, partly in section, of an automaticretractable safety penetrating instrument according to the presentinvention having a modified locking and releasing mechanism.

FIGS. 6A, 6B and 6C are broken side views, partly in section, showing amodified locking and releasing mechanism for use with the instrument ofFIG. 6.

FIG. 7 is a broken side view, partly in section, of an automaticretractable safety penetrating instrument according to the presentinvention having a safety shield.

FIG. 8 is a broken view, partly in section, showing interconnection ofthe shield and penetrating member of FIG. 7 to allow retraction of theshield and penetrating member together or the penetrating member alone.

FIG. 9 is a side view, partly in section, of another embodiment of anautomatic retractable safety penetrating instrument according to thepresent invention in a rest state utilizing a probe for triggeringretraction.

FIGS. 10, 11, 12 and 15 show operating states for the instrument of FIG.9.

FIGS. 14, 15, 16 and 17 are end views of the trocar penetrating memberof the instrument of FIG. 9 showing various positions of the probe.

FIG. 18 is a side view, partly in section, of a modification of theautomatic retractable safety penetrating instrument of FIG. 9 whereinthe penetrating member triggers retraction.

FIG. 19 is a broken perspective of the locking and releasing mechanismof the instrument of FIG. 18.

FIG. 20 is a broken side view, partly in section, of another embodimentof an automatic retractable safety penetrating instrument according tothe present invention having a safety shield for triggering retraction.

FIGS. 21 and 22 are broken perspective views of distal ends for theinstrument of FIG. 20.

FIG. 23 is a broken perspective view of the locking and releasingmechanism of the instrument of FIG. 20.

FIG. 24 is a broken side view, partly in section, of the instrument ofFIG. 20 in the operative position.

FIGS. 25 and 26 are a broken side view, partly in section, and a brokentop view, respectively, of the hub of the instrument of FIG. 20.

FIG. 27 is a broken side view, partly in section, of a modified distalend for an automatic retractable safety penetrating instrument accordingto the present invention.

FIG. 28 is a broken side view, partly in section, of the distal end ofan automatic retractable safety penetrating instrument according to thepresent invention having a cannulated penetrating member.

FIGS. 29 and 30 are exploded views of the distal ends of automaticretractable safety penetrating instruments according to the presentinvention having cannulated penetrating members.

FIG. 31 is a side view of the distal ends of FIGS. 29 and 30 with thesafety probe in the extended position.

FIG. 32 is a perspective view of the cannulated penetrating members ofFIGS. 29 and 30 with the probe in a retracted position.

FIG. 33 is a side view of a trocar-like cannulated penetrating memberfor use with the automatic retractable safety penetrating instrument ofthe present invention.

FIGS. 34, 35 and 36 are perspective top and bottom views of thepenetrating member of FIG. 33 with the probe in a retracted position.

FIG. 37 is a broken side view, partly in section, of an automaticretractable safety penetrating instrument according to the presentinvention wherein retraction is triggered by a shield.

FIG. 38 is a broken side view, partly in section, of an automaticretractable safety penetrating instrument according to the presentinvention having a modified locking and releasing mechanism.

FIGS. 39 and 39a are side and perspective views of locking and releasingmembers for use with the instrument of FIG. 38.

FIG. 40 is an end view of the locking and releasing member for use withthe instrument of FIG. 38.

FIGS. 41, 42 and 43 are broken views showing operation of the lockingand releasing mechanism of the instrument of FIG. 38.

FIG. 44 is a broken view, partly in section, of a modification of thelocking and releasing mechanism of FIG. 38.

FIG. 45 is a broken side view, partly in section, of the locking andreleasing mechanism of FIG. 38 triggered by a safety shield.

FIG. 46 is a broken side view of a modified locking and releasing memberof the type illustrated in FIG. 38.

FIG. 47 is a side view, partly in section, of an automatic retractablesafety penetrating instrument according to the present invention havinga penetrating member formed of a distal end telescoping with respect toa shaft.

FIGS. 48 and 49 are perspective views of retracting springs for theinstrument of FIG. 47.

FIGS. 50 and 51 are broken side views, partly in section, ofmodifications of the instrument of FIG. 47.

FIG. 52 is a broken side view, partly in section, of an automaticretractable safety penetrating instrument according to the presentinvention in combination with a multi-lumenal member in the portalsleeve housing.

FIG. 53 is a broken side view, partly in section, of an automaticretractable safety penetrating instrument according to the presentinvention wherein the locking and releasing mechanism is disposed withina control tube.

FIG. 54 is a side view, partly in section, of an automatic retractablesafety penetrating instrument according to the present invention whereinthe distal end of a penetrating member telescopes with respect the shaftand is triggered for retraction by a safety shield for a probe.

FIG. 55 is a broken side view, partly in section, of an automaticretractable safety penetrating instrument according to the presentinvention wherein the locking and releasing mechanism is located partlyin the hub and partly in the shaft of the penetrating member.

FIGS. 56, 57, 58, 59 and 60 are broken side views, partly in section, ofmodifications of the automatic retractable safety penetrating instrumentaccording to the present invention with various locking and releasingmechanisms.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

An automatic retractable safety penetrating instrument 60 according tothe present invention is illustrated in FIG. 1 and includes an elongatepenetrating member 62, an outer sleeve or cannula, such as portal sleeve64, concentrically disposed around the penetrating member, a hub 66mounting penetrating member 62 and a valve housing 68 mounting portalsleeve 64. The hub 66 can be latched to housing 68 with the use of anysuitable releasable mechanism, such as detents operated by buttons,allowing the hub to be removed from the housing withdrawing thepenetrating member from the portal sleeve. Accordingly, the automaticretractable safety penetrating instrument 60 can be considered to beformed of a portal unit and a penetrating unit, the portal unitincluding portal sleeve 64 and housing 68 and the penetrating unitincluding penetrating member 62 and hub 66.

The penetrating member 62 is preferably made of a medical gradematerial, such as stainless steel, and has an outer diameter or sizedependent upon the surgical procedure to be performed and the anatomicalcavity to be penetrated. The penetrating member 62 is made up of adistal part 70 and a tubular end part 72 concentrically disposed aroundthe distal part with the distal part mounted for longitudinaltelescoping movement relative to the end part. Distal part 70 includesan elongate body 74 which can be cylindrical or have any desiredconfiguration in cross-section terminating distally at a distal end 76of the penetrating member. Distal end 76 terminates distally at a tip 78for penetrating anatomical tissue and proximally at an end wall orshoulder 80 joining the distal end to body 74. The distal end 76 canhave various solid or hollow geometric configurations including varioustrocar, blade and needle distal end configurations such as conical andpyramidal, and the tip 78 can be sharp or blunt and provided with anexternal thread. As shown in FIG. 1, distal end 76 is formed as a trocarhaving a pyramidal configuration with equally spaced end surfaces orfacets 82 tapering distally to a sharp tip 78 and proximally Joined at ajunction 84 to a cylindrical neck 86 terminating proximally at shoulder80. Body 74 terminates proximally at an operating member or flange 88 ata proximal end of the penetrating member, the proximal end beingdisposed in hub 66 with body 74 passing through an opening in a frontwall of the hub. The distal end 76 can be formed integrally, unitarilywith body 74 or the distal end can be formed separately from body 74 andremovably mounted thereon, such as with threads 90, allowing variousdistal ends of diverse configurations to be interchangeably mounted onbody 74. Body 74 has an outer diameter or size that is less than theouter diameter of neck 86 with end part 72 having an inner diametersized to closely receive the outer diameter or size of body 74. End part72 has an outer diameter that is the same as the outer diameter of neck86 such that the neck and end part are closely received by the innerdiameter of the portal sleeve 64. End part 72 terminates distally at astop or abutment 92 proximally spaced from shoulder 80 with theinstrument in an extended position as shown in FIG. 1 and proximally ata retraction member including a retraction plate or flange 94 disposedin hub 66 with the end part passing through the opening in the frontwall of the hub and body 74 passing through an opening in the retractionplate. Body 74 can be hollow or tubular along the length thereof, or thebody can be partly hollow or tubular to receive a control tube 96extending distally from a rear wall of hub 66 and into the proximal endof the penetrating member. Where body 74 is hollow or tubular or formedwith an internal passage along the length thereof communicating with thelumen of the control tube, a channel (not shown) can be disposed indistal end 76 in communication with the lumen or passage of the body toprovide fluid communication entirely through the instrument 60. A valve(not shown), which can be of any conventional design, can be mounted incommunication with the lumen of the control tube, such as along the rearwall of hub 66, to control fluid flow through the instrument. A cauteryattachment can be provided on the penetrating member for electriccautery procedures. A helical coil operating spring 98 is disposedconcentrically around the control tube and connected between operatingflange 88 and the rear wall of the hub to bias the penetrating member ina distal direction. A helical coil balancing, cushion or positioningspring 100 is disposed concentrically around body 74 and connectedbetween retraction plate 94 and the operating flange 88 to bias thepenetrating member in a proximal direction such that the operatingflange is maintained at an initial, rest or balanced position with theinstrument in the extended position as shown in FIG. 1. A retractingmechanism engages the proximal end of the penetrating member andincludes the retraction member, retraction plate 94 in FIG. 1, and ahelical coil retracting spring 102 connected between retraction plate 94and the rear wall of the hub. If required, a guide rod 104 can extendfrom the rear wall of the hub to the front wall thereof passing throughthe retraction plate with the retracting spring concentrically disposedaround the guide rod to provide a guide to maintain the retractingspring in axial alignment.

Hub 66 can be made of any suitable material to be disposable or reusableand has an external configuration to cooperate with housing 68 tofacilitate grasping by a surgeon with one hand for use in penetratingtissue. Hub 66 can have any desired configuration in cross-section andis shown in FIG. 1 as being substantially rectangular. An end cap 106 ofhub 66 has a skirt 108 extending distally through an opening in the hubrear wall, the end cap being mounted for longitudinal movement relativeto the hub by a mounting member including a helical coil mounting spring110 connected between the hub rear wall and a rear wall of the end caprear wall to bias the end cap in a proximal direction. If needed,various mechanisms can be provided in the hub or end cap to limitproximal movement of the end cap relative to the hub.

A locking and releasing or trigger mechanism 112 actuates the retractingmechanism and includes a latch or locking spring having a substantiallyflat base 114 secured to an inner surface of skirt 108 to extend throughthe opening in the hub rear wall and a U-shaped bend 116 disposed in theend cap and proximally joining base 114 to an arm 118. Arm 118 extendsdistally from bend 116 through a slot 120 in the rear wall of the hub,the arm extending in the direction of the retraction plate 94substantially parallel with a longitudinal axis of the instrument. Abent locking finger or member 122 is carried on a distal end of the armto engage the retraction plate 94 when the locking spring is in itsnormal condition as illustrated in FIG. 1. A trigger or releasing member124 including a cam or bend in arm 118 is disposed distally of theoperating flange 88 in the initial position the trigger member 124 beingangled in a distal direction from the arm to cause bending or flexing ofthe arm in a direction outwardly from the instrument longitudinal axiswhen the operating flange is moved distally of the initial position aswill be explained further below. One or more than one additional triggeror releasing members 126 are disposed on arm 118 proximally of theoperating flange 88 in the initial position; and where a plurality oftrigger members 126 are provided, it is preferred that the triggermembers be closely spaced to extend longitudinally along the arm asshown in FIG. 1. The trigger members 126 are angled in a proximaldirection from arm 118 to allow movement of the operating flange therebyin a proximal direction to a set position without causing bending orflexing of arm 118 and to cause bending or flexing of arm 118 in adirection outwardly from the instrument longitudinal axis when theoperating flange is moved distally from the set position toward theinitial position. A detent including a bump, protrusion or cam 128 isprovided on arm 118 distally of bend 116 and proximally of the triggermembers 126. Protrusion 128 has a forward portion angled from arm 118 ina proximal direction to permit distal movement of the protrusion throughslot 120 and a transverse rear portion joined to the forward portion toprevent proximal movement of the protrusion through the slot to lock theend cap relative to the hub when the instrument is in the extendedposition. An end cap release mechanism for releasing the detent from thehub is provided in instrument 60 and includes an actuating device madeup of a pair of actuating buttons 130 externally mounted on end cap 106at diametrically opposing locations with release arms 132 extending frombuttons 130 through skirt 108 in a direction transverse to theinstrument axis to be disposed on opposite sides of bend 116. Buttons130 can have various configurations to move the release arms to squeeze,flatten or compress bend 116 inwardly to align protrusion 128 with slot120, the release arms being moved in a direction aligned with thedirection of squeezing of bend 116 when the buttons are pressed inwardlyin the direction of the instrument axis as will be explained furtherbelow. As shown in FIG. 1, buttons 130 are in the nature of springs 131made of resilient strips of metal, plastic or other spring materialforming lobes having a bulging configuration in a direction outwardlyfrom the instrument axis with the release arms extending therefrom to bemoved by the lobes when the lobes are flattened or collapsed. One ormore than one button 130 can be provided on end cap 106; and, where twobuttons are provided at diametrically opposing locations, bilateralactuation of the end cap release mechanism is facilitated. The releasearms 132 can be arranged in many ways to be aligned with or offset fromone another; and, where only a single button and release arm areprovided, the bend can be compressed between the release arm and theskirt.

Sleeve 64 can be a portal sleeve or cannula as shown in FIG. 1 or anyother tubular structure, such as a catheter for intravenous use,designed to establish communication with an anatomical cavity. Sleeve 64is preferably made of a substantially cylindrical length of rigid orflexible and transparent or opaque material, such as stainless steel orother suitable, medically acceptable, plastic or metal material; and,where the sleeve is made of a flexible material, the penetrating membercan also be made of a flexible material. The sleeve has an outerdiameter dependent upon the size of the penetrating member and thesurgical procedure to be performed, the sleeve typically ranging in sizefrom portal sleeve size to intravenous tube size, with an inner diametersized to closely receive the outer diameters of neck 86 and end part 72.Portal sleeve 64 has a distal end 134 with a configuration to produce asmooth profile with the distal end 70 of the penetrating member when theinstrument is in an operative position to penetrate tissue as will beexplained further below, a proximal end mounted in or formed with afront wall of valve housing 68 and a lumen extending between the distaland proximal ends.

Housing 68 can be made of any suitable material to be disposable orreusable and has a configuration in cross-section corresponding to thecross-sectional configuration of hub 66. A wall 136 extends inwardlyfrom housing 68 at a position distally spaced from the rear end thereofto produce a recess suitable for receiving detents (not shown)releasably securing the hub and housing, the wall 136 having a centralpassage for receiving a valve assembly. The valve assembly can have anyconventional configuration to produce a closed or sealed condition uponremoval of the penetrating unit. As shown in FIG. 1, the valve assemblyis formed as a unitary, one-piece integral construction of rubber orsoft plastic to facilitate sealing to prevent fluid flow through theinstrument when the penetrating unit is removed. The valve assembly isformed of a valve body 138 having a passage therethrough and a proximalflange extending outwardly therefrom to be received in the recess at therear end of the housing. The valve body 138 has a peripheralconfiguration to fit snugly within the passage through wall 136, and avalve member extends distally from valve body 138 and has a normallysealed position with a hemispherical bulging end received in a valveseat formed at an end of the passage to produce a normally closed,sealed configuration. To provide assisted bias toward the sealedconfiguration, a spring member 140 can be imbedded within the valveassembly to bias the valve member toward the valve seat. While the faceof the valve seat is illustrated as being transverse to the longitudinalaxis of the automatic retractable safety penetrating instrument 60, thevalve seat can be angularly oriented.

In use, as shown in FIG. 2 the automatic retractable safety penetratinginstrument 60 is normally provided in a rest state wherein the distalend 76 of penetrating member 62 is retracted within portal sleeve 64 tobe in a safe, protected position, the rest state coinciding with theretracted position for the penetrating member. In the rest state,retracting spring 102 is in a relaxed, unbiased or unloaded statecausing retraction plate 94 to be moved proximally carrying with itpenetrating member 62. Springs 131 are in relaxed states forming lobesextending in a direction outwardly from the instrument axis. Operatingspring 98 and cushion spring 100 are also in relaxed, unloaded orunbiased states; and, accordingly, with the automatic retractable safetypenetrating instrument 60 initially provided in a rest state, no loadingof the springs 98, 100, 102 and 131 exists such that the strength of thesprings is not weakened and shelf life is increased. Where it is desiredto supply the instrument 60 in as small a configuration as possible, endcap 106 can be supplied in a locked position with protrusion 128 lockedwithin the hub and locking and releasing mechanism 112 disengaged fromthe retracting mechanism in the rest position for the instrument. Wherethe instrument 60 can be supplied in a ready position with end cap 106biased proximally relative to the hub as illustrated in FIG. 2, mountingspring 110 can be in an unloaded or relaxed state with protrusion 128disposed proximally of the hub rear wall, and the locking and releasingmechanism 112 can be in a relaxed state with the locking spring in thenormal condition with locking member 122 engaged with retraction plate94. Where the instrument is supplied with the end cap locked within thehub, buttons 130 are depressed causing release arms 132 to move towardeach other squeezing bend 116 to align the rear portion of protrusion128 with slot 120 such that mounting spring 110 automatically moves theend cap proximally, and the instrument will be in the ready positionshown in FIG. 2. When it is desired to utilize the instrument 60 topenetrate tissue and enter an anatomical cavity, the hub and housing aregrasped by a surgeon, and the end cap 106 is squeezed causing movementof the end cap distally relative to the hub such that arm 118 functionsas a push member to move the retraction plate 94 and with it end part 72distally carrying distal part 70 in the distal direction. Continuedsqueezing of the end cap causes the forward portion of protrusion 128 tobe engaged by the hub rear wall such that arm 118 is bent or flexed asmall amount allowing the protrusion 128 to pass through the slot 120and into the hub while the retraction plate 94 remains held by thelocking member 122. Once protrusion 128 has entered the hub, arm 118returns to the normal condition, and the rear portion of the protrusionengages the rear wall of the hub to lock the end cap against proximalmovement at which time the end part 72 will be locked against proximalmovement with the retraction plate 94 locked in place adjacent the frontwall of the hub as shown in FIG. 1. With the instrument 60 in theextended position shown in FIG. 1, the operating flange 88 will be inthe initial position disposed proximally of trigger member 124 anddistally of trigger members 126 and the distal end junction 84 of thepenetrating member will be spaced from the distal end 134 of the portalsleeve by a distance that is the same as the spacing between shoulder 80and abutment 92.

The instrument can now be utilized to penetrate tissue and enter ananatomical cavity. The hub and housing are grasped by the surgeon, andthe instrument is forced against tissue, such as tissue T forming a wallof an anatomical cavity, causing distal part 70 of penetrating member 62to move proximally relative to end part 72 against the bias of operatingspring 98. Abutment of shoulder 80 with stop 92 limits proximal movementof the distal part at which time the instrument will be in an operativeposition illustrated in FIG. 3 with the distal end junction 84 alignedwith the distal end 134 of the portal sleeve to form a substantiallysmooth profile. As distal part 70 moves proximally, operating flange 88moves proximally deflecting trigger members 126 in the proximaldirection such that the operating flange moves proximally therepast to aset position without disengaging the locking member 122 from theretraction plate 94. Once the distal end 134 of the portal sleeve haspassed through the tissue T and entered the anatomical cavity, operatingspring 98 will move distal part 70 distally relative to end part 72causing the operating member 88 to be moved distally from the setposition toward the initial position to engage a trigger member 126distally closest thereto such that arm 118 is flexed or bent in adirection outwardly from the instrument axis causing locking member 122to be moved out of engagement with retraction plate 94. Accordingly,retracting spring 102 will automatically move the retraction member 94and with it the end and distal parts of the penetrating member to theretracted position with the distal tip 78 of the penetrating member in asafe, protected position within the portal sleeve as shown in FIG. 4. Byproviding a plurality of closely spaced trigger members 126, thedistance that the operating member must be moved distally from the setposition prior to retraction can be minimized. Where the operatingmember is moved to a set position that is not proximal of a triggermember 126 due to the resistance of the tissue being small or wheretrigger members 126 are not provided, operating spring 98 will move thedistal part of the penetrating member distally from the set positionupon the portal sleeve distal end entering the anatomical cavity, andthe momentum of the operating spring will override the bias of thecushion spring 100 such that the operating member 88 will be moveddistally of the initial position to engage trigger member 124 and flexarm 118 in a direction outwardly from the instrument axis such that thelocking member 122 is moved out of abutment with retraction plate 94. Byproviding both trigger members 124 and 126, redundant protection isprovided for the automatic retractable safety penetrating instrument 60in that triggering can be obtained via either distal movement of theoperating member from the set position toward the initial position ordistal movement of the operating member past the initial position.

Once the distal end of the instrument 60 has entered the anatomicalcavity and the penetrating member has moved to the retracted position,the portal sleeve will have been introduced into the cavity such thatthe penetrating unit can be withdrawn from the portal unit. When thepenetrating unit is withdrawn, the valve member will return to thebiased position such that the bulging end will engage the valve seat toseal the portal unit from fluid flow therethrough from insufflationpressure. Additionally, the axial length of the passage produces anelongated seal with penetrating member 62 minimizing escape of fluidduring cavity penetration; and, if an instrument of a different sizethan the penetrating member is to be introduced after withdrawal of thepenetrating unit, the valve assembly can be easily interchanged toinstall a valve assembly having a passage of a diameter to seal alongthe different size instrument.

The instrument 60 can be reusable or disposable for single patient use;and, where reusable, instrument 60 can be moved from the retractedposition to the ready position by pushing or depressing buttons 130causing release arms 132 to move toward each other. Accordingly, bend116 will be compressed or flattened such that the rear portion ofprotrusion 128 is aligned with the slot 120 in the hub rear wall causingmounting spring 110 to automatically move the end cap 10 proximallyrelative to the hub. The locking spring will return to the normalcondition with locking member 112 engaged with retraction plate 94, andthe instrument will be in the ready position to be reset in the extendedposition via squeezing operation of the end cap.

Various mechanisms can be utilized in the automatic retractable safetypenetrating instrument in place of or in addition to the end cap for usein setting the instrument in the extended position. As one example, apin and slot arrangement can be used as the resetting mechanism with apin provided on the penetrating member or the retracting mechanism, suchas in the periphery of the retraction plate, to extend through alongitudinal slot in the hub allowing the retracting mechanism to bemoved via manual movement of the pin along the slot when setting theinstrument in the extended position.

While coiled springs are shown in the instrument 60 for the operating,retracting, cushion and mounting springs, many different arrangementsand types of springs or other bias devices can be utilized with thepresent invention, and the bias devices can be arranged in instrument 60in many various ways. Where springs are utilized, the springs can betension, compression or torsion springs. When the operating member isproximally spaced from the trigger member 124 in the initial position,the cushion and operating springs can be of equal strength, and wherethe operating member is engaged with the trigger member 124 in theinitial position, the cushion spring can be of lesser strength than theoperating spring due to the increased resistance provided by the triggermember 124. The cushion spring can be disposed at various locations inthe instrument including within the shaft of the penetrating member toposition the operating member in the initial position. Various single ormultiple piece devices can be utilized as the locking and releasingmechanism to lock the retracting mechanism against movement and to bereleased in response to distal movement of an operating member. Thelocking and releasing mechanism can be mounted for movement around anaxis transverse to the instrument axis as shown in FIG. 1, parallel withthe instrument axis, aligned with the instrument axis and in many otherways. Various types of trigger members including cams, springs withbumps or springs cut to provide extending leaves or triggers, linkagesand many other types of devices can be utilized to trigger retraction inresponse to distal movement of the operating member, and the triggermembers can be provided at any suitable location including on thelocking member or the operating member. Where provided on the lockingmember, the trigger members can be formed integrally, unitarily with thelocking spring or separately therefrom. As shown in FIG. 1, lockingmember 122 and trigger members 124 and 126 are unitarily, integrallyformed of a single strip of resilient, spring material such as metal orplastic. In addition to the penetrating member, various other parts ofthe instrument including the sleeve can be utilized to triggerretraction; and, where the instrument is supplied with a safety shieldor probe, movement of the probe or shield trigger release of theretracting mechanism. Where movement of the shield or probe is utilizedto trigger retraction, retraction can be triggered via movement of anoperating member from the set position toward the initial position ordistally of the initial position. The locking and releasing mechanismcan be arranged in the instrument 60 in many ways; and, depending on thesize of the instrument, the locking and releasing mechanism can bemounted within or externally of the penetrating member, within thecontrol tube, the hub or the housing. Where disposed within thepenetrating member, the locking and releasing mechanism can be mountedat any location along the shaft of the penetrating member including thepenetrating member distal end to be disposed entirely or partiallywithin the penetrating member. The end cap can be mounted on the hub inmany ways with the skirt disposed within or externally of the hub, andvarious bias members can be utilized to bias the end cap. Where securedto the end cap, the locking and releasing mechanism can be provided as amodule facilitating assembly of the automatic retractable safetypenetrating instrument. The locking and releasing mechanism can beutilized as the push member or the push member can be a separate device.Various release mechanisms can be utilized in the instrument 60 to bemanually actuated to release the end cap from the hub, and the releasemechanisms can be mounted on the instrument in many various ways inaccordance with the structure of the locking and releasing mechanism orpush member with the release mechanism of FIG. 1 being particularlyadvantageous for bilateral operation with right and left handcompatibility. The distance that the end cap must be moved proximally inthe ready position will be in accordance with the distance that the pushmember must be moved proximally to be in a position to move theretracting mechanism distally. Accordingly, the length of skirt 108 willdepend upon the distance that the end cap must be moved proximally, andvarious devices such as a bellows can be provided in the instrument tobridge any longitudinal gap or space between the skirt and the hub wherethe skirt is moved outside of the hub in the ready position. Instrument60 can be provided with or without a control tube, although a controltube is desirable to allow fluid flow through the instrument. Controltube 96 can be rotatably mounted and can extend through the end cap toterminate at the end cap rear wall. A valve can be disposed along therear wall of the end cap in communication with the lumen of the controltube to control fluid flow through the instrument where the inner memberis hollow or formed with an internal passage.

A modified locking and releasing mechanism and end cap release arm forthe automatic retractable safety penetrating instrument according to thepresent invention are illustrated in FIG. 5 at 160 wherein the lockingand releasing mechanism 212 is shown without a trigger member. Lockingand releasing mechanism 212 is similar to locking and releasingmechanism 112 and includes a latch or locking spring having a base 214for being secured to the end cap of the automatic retractable safetypenetrating instrument, a U-shaped bend 216 and an arm 218 joined tobase 214 by bend 216. Arm 218 has a locking member 222 at a distal endthereof to engage the retracting member for locking the retractionmechanism of the automatic retractable safety penetrating instrumentagainst movement; and, if desired, arm 218 can be used as the pushmember for use in setting the automatic retractable safety penetratinginstrument in the extended position via squeezing operation of the endcap. A detent or protrusion 228 is disposed on arm 218 distally of bend216 for locking the end cap relative to the hub of the automaticretractable safety penetrating instrument in the extended position.Various trigger members can be provided on the locking spring to beactuated by the operating member to trigger retraction, or the lockingspring can be designed to cooperate with a trigger member provided onthe operating member as will be explained further below. Release arm 218extends into the end cap to terminate at a tapered end 219 forcompressing or squeezing bend 216 when the release arm is moved towardthe locking spring by an actuating device, such as buttons 130, in adirection transverse to the direction of squeezing. Accordingly, bymoving the release arm 218 into the end cap in a direction transverse tothe desired direction of flattening or squeezing of the bend, thetapered configuration of the release arm will progressively flatten orcompress the bend allowing protrusion 228 to move through the slot inthe hub rear wall thusly releasing the end cap.

A modification of the locking and releasing mechanism for the instrument60 is illustrated in FIG. 5A wherein triggers 124 and 126 are mounted ona substrate 121 laminated to arm 118 with triggers 126 and 127 cut fromsubstrate 121 as indicated by apertures 127 to be bent upwardlytherefrom. Accordingly, triggers 126 will flex distally and downwardlylooking at FIG. 5 during proximai movement of the operating member; and,during distal movement of the operating member, the triggers 126 willcause the arm 118 to flex to release the retracting mechanism, thesubstrate providing additional strength to allow repetitive operation ofthe triggers 126.

In the modified locking and releasing mechanism illustrated in FIGS. 5Band 5C, the arm 118 is cut at 119 to allow triggers 124 and 126 toextend therethrough angled proximally to allow operating member 88 topass thereby while flexing the triggers 126 without flexing the arm 118,the operating member having a beveled ends 89 to facilitate proximalmovement thereof. The triggers 124 and 126 extend from a member 123disposed below arm 118 and having a lip 125 engaging the edge of arm 118such that member 123 can flex downwardly looking at FIG. 5C withoutmovement of arm 118 with proximal movement of operating member 88.Upward movement of member 123 is prevented during distal movement ofoperating member 88 such that the arm 118 is caused to deflectdownwardly moving lock 122 from the locked position to a releaseposition actuating the retraction mechanism.

In the modified locking and releasing mechanism illustrated in FIG. 5D,no trigger members 126 are utilized and the trigger 124 is formed of anangled portion of arm 118. The rest position is illustrated in FIG. 5D;and, after movement of operating member 88 rearwardly from the restposition, the operating member will be subsequently moved distally pastthe rest position due to the force from operating spring 98 compressingspring 100. As the operating member 88 moves forwardly of the restposition, the peripheral edge of the operating member, which ispreferably angled at the same angle as the trigger 124, engages thetrigger 124 to move the lock 122 to the release position allowingretraction.

A modification of the automatic retractable safety penetratinginstrument according to the present invention is illustrated at 360 inFIG. 6, only the penetrating unit of the instrument 360 being shown. Theautomatic retractable safety penetrating instrument 360 is similar toautomatic retractable safety penetrating instrument 60; however, theoperating member or flange 388 for the automatic retractable safetypenetrating instrument 360 has a trigger member 326 extending from theperiphery thereof, the trigger member 326 being angled outwardly fromthe operating member in a distal direction. The locking and releasingmechanism 312 for the automatic retractable safety penetratinginstrument 360 includes a latch or locking spring similar to thatdescribed for locking and releasing mechanism 112; however, arm 318 forlocking and releasing mechanism 312 has a plurality of spaced barbs,ratchet teeth or serrations 321 extending longitudinally therealong forbeing successively engaged by trigger member 326.

Operation of automatic retractable safety penetrating instrument 360 issimilar to that described for automatic retractable safety penetratinginstrument 60 in that the operating flange is positioned by theoperating and balancing springs 398 and 400 in an initial position withtrigger 326 disposed distally of some of the barbs 321. Where theinitial position for the trigger member is such that at least one barbis disposed distally of the trigger member, the trigger member can bemaintained in engagement with the nearest distal barb as illustrated inFIG. 6 allowing the cushion spring to be of lesser strength than theoperating spring and for further stability in the initial position.During penetration of anatomical tissue, operating member 388 will bemoved proximally causing trigger member 326 to move proximally past andengage successive barbs 321 such that the penetrating member movesincrementally in a controlled manner until the operating member hasmoved to the set position with the trigger engaged with a distallyclosest barb. Once the distal end of the portal sleeve has entered theanatomical cavity, operating spring 398 will move operating flange 388distally from the set position such that trigger member 326, viaengagement with the distally nearest barb, causes arm 318 to be pivotedand locking member 382 to be released from engagement with retractionplate 394 for immediate retraction upon penetration with minimal distalmovement of the operating flange. By providing a plurality of closelyspaced barbs, trigger member 326 will be engaged with a nearest distalbarb for various set positions ensuring immediate retraction upon distalmovement of the operating member. Where momentum triggering is desired,one or more barbs 321 can be disposed distally of the initial positionto be utilized to pivot the arm 318 upon distal movement of theoperating member distally of the initial position. Where momentumtriggering is utilized, one barb disposed distally of the initialposition should be sufficient to trigger retraction; however, more thanone barb can be provided for increased safety. The automatic retractablesafety penetrating instrument 360 can be used with or without momentumtriggering; and, where momentum triggering is provided in addition totriggering by distal movement of the operating member from the setposition toward the initial position, redundant protection is provided.

A modification of the instrument 360 is shown in FIG. 6A wherein teethor barbs 321 are formed of flexible members while operating member 388has a beveled end 389 whereby the configuration of the teeth 321 and theoperating member 388 allows flexing of the teeth as the operating membermoves proximally thereby but, during distal movement of the operatingmember upon entry into an anatomical cavity, the arm 318 will be flexedto release lock 322 and actuate retraction.

In the modification of FIGS. 6B and 6C for use with instrument 360, thetrigger 326 is replaced with a pivotal member 327 having an angledsurface to facilitate movement past teeth 321. The pivotal member 327shown in FIG. 6B is mounted on a pivot 329 on the peripheral edge ofoperating member 388 and the pivotal member has a triangular shape suchthat the member can pivot only counterclockwise looking at FIG. 6B.Accordingly, the pivotal member 328 can pivot to allow proximal movementof the operating member 388 but, upon distal movement of the operatingmember, will cause the arm 318 to flex to actuate the retractionmechanism. In FIG. 6C, pivotal member 327' is mounted on a pivot 331 toform a transversely extending operating member which can pivot onlycounterclockwise looking at FIG. 6C due to a protrusion 333 preventingclockwise pivoting. Accordingly, member 327' will pivot during proximalmovement but will cause arm 318 to deflect to actuate the retractingmechanism upon distal movement.

Another modification of the automatic retractable safety penetratinginstrument according to the present invention is illustrated at 460 inFIG. 7, only the penetrating unit of the instrument 460 being shown. Theautomatic retractable safety penetrating instrument 460 is similar toautomatic retractable safety penetrating instrument 60 except that asafety shield 463 is concentrically disposed around the penetratingmember 462 with the penetrating member including a body 474 terminatingproximally at retraction plate or flange 494 disposed in hub 466. Safetyshield 463 has a distal end 467 disposed beyond the tip 478 of thepenetrating member when the instrument is in an extended position asshown in FIG. 7 and a proximal end terminating at an operating member orflange 488 disposed in hub 466. A helical coil operating spring 498 isconcentrically disposed around the penetrating member and connectedbetween operating flange 488 and retraction plate 494 to bias the safetyshield in a distal direction. A helical coil cushion spring 500 isdisposed concentrically around the safety shield and connected betweenthe front wall of the hub and the operating flange 488 to bias thesafety shield in a proximal direction such that the operating flange ismaintained at an initial position with the instrument in the extendedposition as shown in FIG. 7. A helical coil retracting spring 502disposed around guide rod 504 is connected between retraction plate 494and the front wall of the hub. Hub 466 and end cap 506 are similar tohub 66 and end cap 106 with end cap 506 being mounted for longitudinalmovement relative to the hub and biased in a proximal direction by abias member including a mounting spring 510. A locking and releasing ortrigger mechanism 512 for actuating the retracting mechanism includes alatch or locking spring similar to that described for locking andreleasing mechanism 112 except that arm 518 for locking and releasingmechanism 512 includes a proximal portion angled from the protrusion 528to extend distally in the direction of a longitudinal axis of theinstrument and a distal portion bent from the proximal portion to extenddistally in a direction outwardly from the longitudinal axis, the distalportion terminating distally at the locking finger or member 522 engagedwith the retraction plate 494 when the locking spring is in its normalcondition as illustrated in FIG. 7. An extension 523 of arm 518 extendsdistally from the locking member substantially parallel with theinstrument longitudinal axis. A plurality of trigger members 524 aredisposed longitudinally along the extension at spaced locationstherealong with a most proximal one of the trigger members 524positioned distally of the operating member in the initial position asillustrated in FIG. 7. A plurality of trigger members 526 extendlongitudinally along extension 523 at spaced locations therealong with amost distal one of the trigger members 526 disposed proximally of theoperating member in the initial position. When the trigger members areformed of or cut from the material of the locking spring as shown inFIG. 7, an extra layer or strip of material 525 can be provided on arm518 including extension 523 for additional strength. As best illustratedin FIG. 8, a nub 489 extends radially inwardly from an inner surface ofthe wall of the safety shield 463, the nub extending from the operatingflange 488. A longitudinal slot 491 is formed in the penetrating member462 to receive the nub such that, with the operating flange in theinitial position, the nub is disposed at a distal end of the slot inengagement with the wall of the penetrating member.

Operation of the automatic retractable safety penetrating instrument 460is similar to that previously described for automatic retractable safetypenetrating instrument 60 in that the instrument 460 is normallyprovided in a rest state and is moved to the ready position by releasingend cap 506 from hub 466 via actuation of buttons 530. The instrument ismoved to the extended position illustrated in FIG. 7 via squeezingoperation of the end cap 506 causing the retracting mechanism to bemoved distally by the arm 518 to lock the retraction plate 494 in placeagainst the locking member 522 with the end cap held in place byprotrusion 528 within the hub. With the instrument 460 in the extendedposition, the operating member 488 will be in the initial positiondisposed proximally of a most proximal one of the trigger members 524and distally of a most distal one of the trigger members 526, the distalend junction 484 of the penetrating member will be substantially alignedwith the distal end of the portal sleeve and the distal end 467 of thesafety shield will extend beyond the tip 478 of the penetrating membersuch that the penetrating member is in a safe, protected position. Whenthe instrument 460 is forced against tissue to enter an anatomicalcavity, the safety shield 463 will be moved proximally causing theoperating member 488 to move to a set position with trigger members 526deflecting proximally allowing movement of the operating membertherepast. Movement of the safety shield causes nub 489 to be movedproximally within the longitudinal slot 491 as shown in dotted lines inFIG. 8, and a proximal end of the slot can serve as a stop or abutmentlimiting proximal movement of the safety shield. Once the distal end ofthe portal sleeve 464 has entered the anatomical cavity, the operatingspring 498 will move the safety shield distally causing the operatingmember 488 to move distally toward the initial position and engage thedistally closest trigger member 526 to flex the locking spring andrelease the retraction plate 498 from the locking member 522. Once theretraction plate is released, retracting spring 502 will automaticallymove the penetrating member 462 proximally to a retracted position, thepenetrating member carrying with it the safety shield 463 due toengagement of the penetrating member wall with the nub 489. Accordingly,both the penetrating member and safety shield distal ends can beretracted within the portal sleeve minimizing extension of the automaticretractable safety penetrating instrument into the anatomical cavity.Where trigger members 526 are not provided or the set position is suchthat there is no trigger member 526 between the initial and setpositions, trigger members 524 can be utilized to trigger retraction inthat the momentum of the operating spring upon penetration into theanatomical cavity overrides the bias of the cushion spring to move theoperating member distally of the initial position causing the operatingmember to engage a trigger member 524 and flex the locking spring torelease the retraction plate. Where the nub 489 and slot 491 are notprovided, the penetrating member alone will be retracted uponpenetration through the tissue with the safety shield remainingextended. Instrument 460 can be designed to allow removal of thepenetration member and the safety shield together or individually fromthe portal sleeve.

Another modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated in FIG. 9at 560. The automatic retractable safety penetrating instrument 560includes a penetrating member 562, a portal sleeve 564 concentricallydisposed around the penetrating member, a probe 565 disposed within thepenetrating member, a hub 566 mounting penetrating member 562 and probe565 and a valve housing 568 mounting portal sleeve 564. The hub 566 canbe latched to housing 568 with detents formed on the hub at a forwardend thereof, the detents being in the nature of beads or protrusions forbeing snapped or locked in place in recesses formed along an innersurface of the wall of the housing at a rear end thereof. The detentscan be frictionally retained in the recesses allowing the hub to beremoved from the housing with manual force such that the penetratingunit can be removed from the portal unit. The penetrating member 562 issimilar to penetrating members 462 and has a distal end 576 with apyramidal configuration defined by equally spaced end surfaces or facets582 tapering distally to a tip 578 and terminating proximally at ascalloped junction 584 joining the facets to an elongate body 574, thebody 574 terminating proximally at a retraction plate 594 disposed inhub 566. Probe 565 includes an elongate member which can be cylindricalor have any other desired configuration in cross section terminatingdistally at a blunt tip 569 extending through an aperture in one of thefacets and proximally at an operating member 588. The probe can besolid, hollow or tubular or partly hollow or tubular; and, as shown inFIG. 9, the probe 565 is in the nature of a solid, cylindrical rod, baror wire having a minimal outer diameter or size with a relativelythicker piece of material joined proximally to the bar at a right anglethereto to define the operating member 588. Body 574 can be hollow ortubular or formed with an internal passage along the length of thepenetrating member with the probe disposed in the lumen or passage ofthe body to be laterally offset from a longitudinal axis of theinstrument 560 as shown in FIG. 9 or aligned with the instrument axisincluding being concentrically disposed within the penetrating member. Apush member 571, which can be solid or tubular, extends distally througha rear wall of hub 566 and into a proximal end of the penetrating memberfor setting the instrument in the extended position shown in FIG. 9, thepush member being aligned with the instrument longitudinal axis with theprobe laterally offset therefrom. A helical coil operating spring 598 isconnected between operating flange 588 and the rear wall of the hublaterally offset from the push member to bias the probe in a distaldirection. A helical coil cushion spring 600 is connected between theoperating flange 588 and the retraction plate 594 to bias the probe in aproximal direction against the distal bias of the operating spring suchthat the operating member is maintained at an initial position with theinstrument in the extended position as illustrated in FIG. 9. A helicalcoil retracting spring 602 is connected between retraction plate 594 anda rear wall of the hub to bias the retraction member proximally. The hubrear wall has an opening therein allowing passage therethrough by thepush member 571, and a tubular collar 573 extends proximally, externallyfrom the hub rear wall with the push member 571 extending proximallythrough the collar to terminate at an external knob 575 for rotating thepush member around an axis aligned with the instrument longitudinalaxis. A helical or spiral-like groove 577 is formed in an outer surfaceof the push member to receive a cam or pin 579 mounted externally alongthe hub rear wall and extending into the lumen of the collar such thatrotation of the push member around the instrument axis produceslongitudinal movement of the push member relative to the hub. With thepush member fully inserted in the hub such that knob 575 abuts thecollar 573 as shown in FIG. 9, the pin 579 is received in a proximal endof the groove 577, and a nub 581 protruding from the control tubedistally of the groove is longitudinally aligned with a longitudinalslot 583 in the penetrating member, the slot extending through theretraction plate 594. The locking and releasing mechanism 612 foractuating the retracting mechanism includes a latch or locking springsimilar to the locking spring for locking and releasing mechanism 112except that no trigger members 126 are provided and trigger member 624is made from a portion of arm 618 angled in a distal direction towardthe instrument longitudinal axis to be disposed distally of theoperating member in the initial position.

In use, the automatic retractable safety penetrating instrument 560 isnormally provided in a rest state with the distal end 576 of thepenetrating member 562 retracted within portal sleeve 564 to be in asafe, protected position, the rest state coinciding with the retractedposition for the penetrating member illustrated in FIG. 12. In the reststate, push member 571 is fully inserted in hub 566 with pin 579disposed at a proximal end of the groove 577 and hub 581 disposed in thelongitudinal slot 583 at a distal end thereof. When it is desired toutilize the instrument 560 to penetrate tissue and enter an anatomicalcavity, knob 575 is rotated counterclockwise looking distally at FIG. 12such that pin 579 and groove 577 cause the push member 571 to moveproximally, longitudinally relative to the hub withdrawing the pushmember therefrom until a distal end of the groove 577 is disposed in thecollar 573 with the pin 579 received therein in a ready position for theinstrument as illustrated in FIG. 13. With the push member 571withdrawn, the nub 581 is no longer longitudinally aligned with the slot583 but, rather, is aligned with a solid portion of the retraction plate594 offset 180° from the slot. The knob 575 is then rotated clockwiselooking distally at FIG. 13 causing movement of the push member 571longitudinally into the hub with movement of the retraction platedistally via engagement with nub 581. Once the push member has beenfully inserted in the hub, the instrument will be in the extendedposition shown in FIG. 9 with the retraction plate 594 locked in placeagainst the locking member 622 and the nub 581 longitudinally alignedwith the slot 583. In the extended position, the junction 584 will besubstantially aligned with the distal end of the portal sleeve and thedistal end 569 of the probe 565 will be disposed beyond the facet or endsurface 582 with the cushion and operating springs positioning theoperating member in the initial position proximally of the triggermember 624. When the instrument 560 is forced against tissue, such astissue T forming a wall of an anatomical cavity, the probe 565 will bemoved proximally as shown in FIG. 10 causing the operating member 588 tobe moved proximally without bending or flexing the arm 618. Once adistal end of the sleeve 564 has entered the anatomical cavity, theprobe 565 will be moved distally, and the momentum of the operatingspring 598 moves the operating member 588 distally of the initialposition to engage trigger member 624 and flex arm 618 in a directionoutwardly from the instrument axis to release the retraction plate 594as illustrated in FIG. 11. Once the retraction plate is released,retracting spring 602 automatically moves the penetrating member andwith it the probe to a retracted position with the slot 583 moving alongthe nub 581. In the retracted position, the tip 578 of the penetratingmember is disposed within the portal sleeve and the tip of the probe isdisposed within the penetrating member as illustrated in FIG. 12. Theinstrument 560 can be reset in the extended position by withdrawing pushmember 571 from the hub to align nub 581 with the solid portion of theretraction plate and reinserting the push member in the hub to move theretracting mechanism distally.

The probe 565 can be arranged in the penetrating member 562 in manyvarious ways, and FIGS. 14-17 illustrate by way of example alternativearrangements for the probe within the penetrating member where the probeis offset from a longitudinal axis of the penetrating member. In FIG.14, the penetrating member distal end includes three equally spaced endsurfaces or facets 582 joined along three edges 585 terminating distallyat tip 578 and proximally at a junction joining the facets to body 574with the probe 565 protruding through one of the end surfaces inwardlyof the junction, i.e. inwardly of the circumference of body 574, asubstantially equal angular distance from the edges 585 of the one endsurface. The penetrating member of FIG. 15 includes three equally spacedend surfaces 582 joined along edges 585 with the probe 565 protruding inpart through two adjoining end surfaces 582 inwardly of thecircumference of the body 574 and along the edge 585 Joining the two endsurfaces. In FIG. 16, the penetrating member includes three equallyspaced end surfaces 582 joined along edges 585 with the probe 565protruding in part through two adjoining end surfaces along the edge 585joining the two end surfaces and along the circumference of the body574. The penetrating member of FIG. 17 includes three equally spaced endsurfaces 582 joined along edges 585 with the probe 565 protrudingthrough one of the end surfaces along the circumference of the body 574a substantially equal angular distance from the edges of the one endsurface. It will be appreciated that the arrangements for the probeillustrated in FIGS. 14-17 are exemplary only and that the probe can bearranged in the penetrating member in many various ways in accordancewith the structure for the probe and the configuration of thepenetrating member. By positioning the probe to protrude from thepenetrating member close to the junction 584 and the circumference ofbody 574, retraction of the penetrating member immediately upon thesleeve distal end entering the anatomical cavity can be realized.

Another modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated at 660 inFIG. 18. Penetrating member 662 of instrument 660 is made up of a distalpart 670 and an end part 672, the distal part 670 having a distal end676 defined by end surfaces 682 tapering distally to tip 678 andterminating proximally at a scalloped junction 684 joining the facets toa cylindrical neck 686 which in turn is joined to an elongate body 674having an outer diameter or size less than the outer diameter of neck686. Body 674 extends proximally from neck 686 to terminate at an endflange 687 disposed in the end part with body 674 passing through anopening in a forward wall of the end part. The end part forward wall isrigidly held between the end flange and a projection or plate 693 onbody 674 such that the distal and end parts move together as a unit. Endpart 672 terminates proximally at an operating member or flange 688 at aproximal end of the penetrating member disposed in hub 666, the end partbeing hollow or tubular or formed with an internal passage to receive apush member 671 that is the same as push member 571 for setting theinstrument in the ready and extended positions as was described forautomatic retractable safety penetrating instrument 560. Operatingspring 698 is connected between operating flange 688 and the rear wallof the hub to bias the penetrating member in a distal direction, andcushion spring 700 is connected between the operating flange and aretraction plate 694 disposed in the hub distally of the operatingmember to maintain the operating member at an initial position with theinstrument in the extended position as shown in FIG. 18. As bestillustrated in FIG. 19, retraction plate 694 has an opening thereinallowing passage therethrough by the end part 672 with a leg 695 and anextension 697 extending proximally from the retraction plate atdiametrically opposing locations. The leg 695 and extension 697 extendthrough respective slots in the operating flange 688 with retractingspring 702 connected between the leg 695 and the rear wall of the hub tobias the retraction plate in a proximal direction. A locking andreleasing mechanism 712 for actuating retraction of the penetratingmember includes a locking spring similar to that described for lockingand releasing mechanism 612 except that trigger member 724 is disposeddistally of locking member 722, the trigger member 724 being disposed onan extension 723 of arm 718. Extension 723 extends distally from lockingmember 722 with trigger member 724 disposed distally of the operatingmember in the initial position and the locking member in engagement withthe extension 697 of the retraction plate in the normal condition forthe locking spring illustrated in FIG. 18.

Operation of the automatic retractable safety penetrating instrument 660is similar to that previously described for instrument 560 in that thepush member 671 can be utilized to move the instrument from the rest tothe ready position and thereafter to the extended position illustratedin FIG. 18 with the junction 684 of the penetrating member disposedbeyond a distal end of the portal sleeve and the retraction plate 694locked in place via engagement of extension 697 with the locking member722 and the operating member 688 in the initial position disposedproximally of the trigger member 724. When the instrument 660 is forcedthrough tissue to enter an anatomical cavity, the penetrating member 662will be moved proximally causing proximal movement of the operatingflange 688 to a set position with the locking member 722 serving as astop or abutment limiting proximal movement of the operating flange.Upon the portal sleeve distal end entering the anatomical cavity, theoperating flange will move distally, and the momentum of the operatingspring 698 will cause movement of the operating member distally of theinitial position to engage trigger member 724 and flex the lockingspring to release the retraction plate 794.

An additional modification of an automatic retractable safetypenetrating instrument according to the present invention is illustratedat 760 in FIG. 20, the instrument 760 being similar to automaticretractable safety penetrating instrument 460 in that movement of asafety shield distally upon a distal end of the portal sleeve enteringan anatomical cavity is utilized to trigger retraction. As illustratedin FIGS. 20 and 22, the penetrating member 762 for automatic retractablesafety penetrating instrument 760 has a distal end 776 defined by aplurality of facets 782 terminating distally at tip 778 and proximallyat a junction 784 joining the facets to a body 774. As illustrated inFIGS. 20 and 21, the safety shield 763 has a distal end 767 joined to anelongate body concentrically disposed around the body of the penetratingmember, the safety shield distal end being defined by one or more endsurfaces 801 for being disposed along a corresponding facet or facets782 of the penetrating member when the instrument is in an operativeposition during penetration of tissue as shown in FIG. 21. The endsurfaces 801 of the safety shield are disposed at an angle with alongitudinal axis of the instrument 760 that is the same as the anglethat the corresponding facet or facets 782 are disposed with thelongitudinal axis such that the safety shield distal end completes orconforms to the geometric configuration of the penetrating member in theoperative position. The penetrating member and safety shield distal endscan have various configurations to produce a predetermined solid orhollow geometric configuration in the operative position. Body 774terminates proximally at a retraction plate 794 disposed in hub 766, andone or more than one retracting spring 802 is connected betweenretraction plate 794 and the rear wall of the hub to bias thepenetrating member in a proximal direction, one retracting spring beingillustrated in FIG. 20 and two retracting springs being illustrated inFIG. 24. The safety shield terminates proximally at an operating member788 disposed in hub 766 with an operating spring 798 disposedconcentrically around the penetrating member and connected between theretraction plate 794 and the operating flange 788 to bias the safetyshield in a distal direction. An end cap 806 similar to end cap 106 ismounted for longitudinal sliding movement relative to the hub by biasmembers including mounting springs 810 connected between the hub rearwall and the rear wall of the end cap to bias the end cap in a proximaldirection. As best illustrated in FIGS. 20 and 23, a locking andreleasing mechanism 812 for the instrument 760 includes a locking springsimilar to that described for locking and releasing mechanism 712 inthat arm 818 has an extension 823 extending distally from the lockingmember 822 to carry a trigger member 826 pivotally mounted on extension823. Trigger member 826 includes a trigger cam 827 angled in a proximaldirection and a leg 829 disposed parallel with extension 823 to allowproximal movement of the operating flange past the trigger cam withoutcausing flexing of arm 818 and to cause flexing of arm 818 in responseto distal movement of the operating member against the trigger cam. Anotch or slot 833 can be formed in the retraction plate 794 tofacilitate assembly of the instrument 760.

Operation of the automatic retractable safety penetrating instrument 760is similar to that previously described for automatic retractable safetypenetrating instrument 460 in that the instrument can be supplied in arest state and moved to a ready position illustrated in FIG. 20 byreleasing the end cap 806 from the hub 766. In the ready position, thepenetrating member 762 and safety shield 763 are in a retracted positionwith end cap 806 biased proximally. End cap 806 is moved distally to setthe instrument in the extended position illustrated in FIG. 24, the arm818 serving as a push member for moving the retracting mechanismdistally via engagement of the locking member 822 with the retractionplate 794. Once the protrusion 828 has entered the hub through the slotin the hub rear wall, the end cap will be locked in place at which timethe retraction plate 794 is locked or held in place against the lockingmember 822. With the instrument in the extended position, the junction784 of the penetrating member will be aligned with the distal end of theportal sleeve, and the distal end of the safety shield will be disposedbeyond the tip 778 of the penetrating member. When the instrument 760 isforced through tissue forming a wall of an anatomical cavity, the safetyshield will move proximally causing proximal movement of the operatingmember 788 past the trigger cam 827 without causing flexing of arm 818.In the operative position, the end surfaces 801 of the safety shieldwill be disposed along the corresponding facets 782 of the penetratingmember to produce a predetermined geometric configuration. Once thedistal end of the portal sleeve has entered the anatomical cavity, thesafety shield 763 will be moved distally causing distal movement of theoperating member 788 to engage trigger cam 827 and pivot leg 829 causingarm 818 to flex and release the retraction plate 794. Accordingly,retracting spring 802 will move the penetrating member and with it thesafety shield to the retracted position shown in FIG. 20.

As illustrated in FIGS. 25 and 26 the hub 766 can have a side wallthereof formed with a central recessed channel 835 with a slot 837formed in the hub wall to be disposed in the recessed channel. The slot837 includes a longitudinal slot portion 839, a proximal transverse slotportion 841 and a distal transverse slot portion 843. A pin 845 isthreadedly secured on the penetrating member, such as in the peripheryof retraction plate 794, the pin 845 extending through the longitudinalslot portion 839 to terminate at an external knob 818 with the locationof the proximai transverse slot portion 841 corresponding to thelocation of the pin 845 in the extended position. A pin 847 is securedto the safety shield, such as in the periphery of the operating flange788, the pin 847 similarly extending through the longitudinal slotportion 839 to terminate at an external knob with the location of thedistal transverse slot portion 843 corresponding to the location of thepin 847 in the extended position. The length of the longitudinal slotportion is sufficient to allow movement of the safety shield and thepenetrating member between the extended and retracted positions with theknobs moving within the longitudinal slot portion. Where retraction isnot desired, the pin 845 can be moved into the proximal transverse slotportion 841 preventing retraction of the penetrating member and safetyshield such that the safety shield distal end is disposed beyond the tipof the penetrating member upon the portal sleeve distal end entering ananatomical cavity for use as a standard safety trocar instrument. Whereit is desired to penetrate tissue with the safety shield distal enddisposed beyond the tip of the penetrating member, pin 847 can be movedinto the distal transverse slot portion 843 to lock the safety shieldagainst proximal movement; and, accordingly, retraction of thepenetrating member will be prevented. Where the safety shield distal enddoes not complete the configuration of the penetrating member distal endin the operative position and it is desired that the safety shielddistal end be locked in a position substantially aligned with the portalsleeve distal end for use as a standard trocar instrument, anintermediate transverse slot portion 849 can be provided along the slot837 corresponding in location to the location of pin 843 when the safetyshield is in the retracted position allowing the pin 847 to be movedinto the intermediate transverse slot portion as shown in dotted linesin FIGS. 25 and 26. A probe can be used with the instrument 760 totrigger retraction; and, as shown in FIG. 22, a probe 765 can be mountedwithin the penetrating member 762 to extend through a hole in an endsurface or facet 782. Various types of release mechanisms can be usedwith the instrument 760 to release the end cap from the hub allowing theinstrument to be reset in the extended position.

A modification of the automatic retractable safety penetratinginstrument according to the present invention is illustrated at 860 inFIG. 27 wherein safety shield 863 includes a distal end 867 having aconfiguration that is the same as the configuration of the distal end876 of the penetrating member 862 such that the safety shield can beutilized to cut tissue when disposed beyond the distal end of thepenetrating member as illustrated in FIG. 27. As shown in FIG. 27,distal end 867 of safety shield 863 has a plurality of end surfaces orfacets 901 tapering distally to a sharp tip 903, and the penetratingmember distal end 876 includes a plurality of corresponding facets 882tapering distally to sharp tip 878 with the facets 901 of the safetyshield being disposed at an angle with the longitudinal axis of thepenetrating member that is the same as the angle that the facets 882 aredisposed with the longitudinal axis. By forming the safety shield distalend of a severable material, the distal end 867 of the safety shield canbe cut prior to use to remove the sharp tip 903 where use of the safetyshield to cut tissue is not desired.

Another modification of the automatic retractable safety penetratinginstrument according to the present invention is illustrated at 960 inFIG. 28 wherein the penetrating member 962 is in the nature of acannulated needle having a distal end 976 defined by an angled edge 982terminating distally at a sharp tip 978. A safety probe 965 is disposedconcentrically within the penetrating member, the safety probe 965having a distal end 969 with an angled end surface 905. The edge 982 ofthe penetrating member is disposed at an angle with the longitudinalaxis of the penetrating member that is the same as the angle that theend surface 905 is disposed with the axis such that the probe andpenetrating member form a substantially smooth, solid geometricconfiguration in the operative position. Instrument 960 can be designedto allow removal of the probe and the penetrating member together orindividually from the portal unit, and the probe can remain extendedbeyond the distal end of the portal sleeve upon retraction of thepenetrating member as was described for the safety shield in instrument760.

Another embodiment of an automatic retractable safety penetratinginstrument according to the present invention is illustrated in FIG. 29wherein a hollow penetrating member 1062 is partially solid having apassage 1007 therethrough of a semi-circular configuration incross-section. A distal end 1076 of the penetrating member has apartially conical configuration terminating at a sharp tip 1078 fromwhich extends a peripheral edge 1082 forming an opening in the distalend of the penetrating member. A safety probe 1065 is formed of a solidelongate member 1009 having a semi-circular configuration incross-section and terminating at a distal end 1069 having a partiallyconical configuration corresponding to the configuration of the distalend of the penetrating member.

In the extended position, the distal end 1069 of the safety probe willprotrude beyond sharp tip 1078 to protect the tip as shown in FIG. 31;and, during penetration of tissue, the safety probe will move to theretracted position as shown in FIG. 32 such that the distal end 1069 ofthe safety probe is positioned within the opening formed by peripheraledge 1082 in substantial alignment to form, with distal end 1076 of thepenetrating member, a solid geometrical configuration similar to atrocar. By utilizing the positive stop mechanisms previouslyillustrated, the safety probe will be prevented from retracting furtherthan the position corresponding with the configuration of thepenetrating member such that the conical configuration of thepenetrating distal end of the safety penetrating instrument is assuredas shown in FIG. 32.

FIG. 30 shows a modification of the automatic retractable safetypenetrating instrument of FIG. 29 wherein a penetrating member 1062' hasthe same external configuration as penetrating member 1062 but istubular and the safety probe 1065' has an elongate member of circularconfiguration in cross-section corresponding to the tubularconfiguration of the penetrating member. The safety penetratinginstrument of FIG. 30 will assume the same configuration as the safetypenetrating instrument of FIG. 29 in the extended position as shown inFIG. 31 and the retracted position as shown in FIG. 32.

A modification of the automatic retractable safety penetratinginstrument of FIG. 29 is illustrated in FIGS. 33, 34, 35 and 36 whereinthe safety probe and penetrating member cooperate to produce a solidgeometric pyramid configuration. More particularly, a hollow penetratingmember 1162, which can be either tubular similar to the penetratingmember illustrated in FIG. 30 or have a passage therethrough similar tothe penetrating member illustrated in FIG. 29, has a distal end 1176having a partial geometric configuration of a pyramid with sides orfacets 1182 tapering to a sharp tip 1178 while an opening in the distalend defined by a peripheral edge 1182' terminates at sharp tip 1178. Asafety probe 1165 has a cross-sectional configuration corresponding tothat of the hollow penetrating member and has a distal end 1169 formedof sides or facets 1201 tapering to a narrow end, the configuration ofthe distal end 1169 cooperating with the configuration of the distal end1176 of the penetrating member, when the safety probe is in theretracted position as illustrated in FIGS. 34 and 35, to produce asubstantially complete geometric pyramid configuration having four sidesor facets symmetrically arranged around a sharp point 1178.

Still a further modification of an automatic retractable safetypenetrating instrument according to the present invention is illustratedin FIG. 37 at 1260, the instrument 1260 being similar to automaticretractable safety penetrating instrument 760 except that safety shield1263 for automatic retractable safety penetrating instrument 1260terminates distally at a peripheral scalloped edge 1213 and proximallyat an operating member or flange 1288 disposed in hub 1266 with cushionspring 1300 disposed around the body of the safety shield and connectedbetween the operating flange 1288 and the front wall of the hub.Operating spring 1298 is disposed around the penetrating member andconnected between the operating member and the retraction plate 1294such that the operating member 1288 is maintained at an initial positionwith the instrument in the extended position illustrated in FIG. 37. Thelocking and releasing mechanism 1312 for automatic retractable safetypenetrating instrument 1260 is similar to the locking and releasingmechanism 812; however, the locking spring for locking and releasingmechanism 1312 has two protrusions 1328 and 1328' with protrusion 1328'distally spaced from protrusions 1328.

Operation of automatic retractable safety penetrating instrument 1260 issimilar to that previously described in that instrument 1260 is moved tothe extended position via squeezing operation of end cap 1306 causingarm 1318 to move retraction plate 1294 distally until protrusion 1328enters the hub at which time the end cap 1306 will be locked in placewith protrusion 1328' disposed within the hub distally of protrusion1328 and the retraction plate 1294 locked in place against the lockingmember 1322. In the extended position, operating flange 1288 will bedisposed in the initial position proximally of trigger cam 1327, and thedistal edge 1213 of the safety shield will be disposed proximally of thetip 1278 of the penetrating member 1262. When the instrument 1260 isforced through tissue to enter an anatomical cavity, safety shield 1263will be moved proximally causing proximal movement of operating flange1288; and, upon the portal sleeve distal end entering the anatomicalcavity, operating flange 1288 will be moved distally of the initialposition to engage trigger cam 1327 and pivot leg 1329 thusly flexingarm 1318 to release retraction plate 1294. Accordingly, retractingspring 1302 will move the penetrating member and with it the safetyshield proximally causing the retraction plate 1294 to engage protrusion1328' such that arm 1398 is pivoted in a direction outwardly from alongitudinal axis of the instrument causing protrusion 1328 to bealigned with the slot 1320 in the hub rear wall to automatically releasethe end cap in response to movement of the penetrating member to theretracted position.

An additional modification of an automatic retractable safetypenetrating instrument according to the present invention is illustratedat 1360 in FIG. 38. Automatic retractable safety penetrating instrument1360 is similar to automatic retractable safety penetrating instrument60 except that the operating member, the retraction member, the lockingand releasing mechanism, the push member and the valve assembly forinstrument 1360 are different than those for instrument 60. Thepenetrating member 1362 for automatic retractable safety penetratinginstrument 1360 terminates proximally at an operating member or flange1388 having an ear 1315 projecting outwardly therefrom; however,depending on the configuration for the operating flange, ear 1315 neednot be provided. The retraction member for instrument 1360 is in thenature of a U-shaped member defining a retraction plate 1394, a forwardor engagement wall 1351 distally spaced from the retraction plate and aconnecting or sidewall 1353 joining the engagement wall to theretraction plate with the penetrating member 1362 passing through a holein the engagement wall 1351. Operating spring 1398 is disposedconcentrically around control tube 1396 and connected between theoperating flange 1388 and the retraction plate 1394 to bias thepenetrating member distally with operating flange 1388 in abutment withthe engagement wall 1351. Retracting spring 1402 is disposedconcentrically around control tube 1396 and connected between the rearwall of the hub 1366 and the retraction plate 1394 to bias theretracting member in a proximal direction. The locking and releasingmechanism 1412 for automatic retractable safety penetrating instrument1360 is best shown in FIGS. 39, 39a and 40 and includes a latch orlocking spring having a base 1414 for being secured to a wall of hub1366 with arm 1418 joined to base 1414 by a bend or angle 1416, the arm1418 being in the nature of a plate or flat piece of material. A lockingmember 1422 protrudes beyond a longitudinal edge of arm 1418 to engageretraction plate 1394 and prevent proximal movement thereof in a normalcondition for the latch in the extended position for the instrumentillustrated in FIG. 38. A trigger or release member 1426 protrudes fromthe longitudinal edge parallel with and distally spaced from the lockingmember 1422, the trigger member 1426 being disposed in the normalcondition in the path of longitudinal movement of ear 1315 or operatingflange 1388 where ear 1315 is not provided. Arm 1418 can be bent frombase 1414 at a right angle along bend 1416 as shown in FIG. 39, or thearm can be joined to the base by a curved U-shaped bend 1416 asillustrated in FIG. 39a allowing arm 1418 to pivot around a pivot axisextending along the angle or bend. Locking member 1422 is in the natureof a cylindrical protrusion or pin, and trigger member 1426 is in thenature of a flat strip of material angled in a proximal direction fromarm 1418 to allow proximal movement of ear 1315 thereby without causingpivoting of arm 1418. Various mechanisms including a pin secured on theretracting member and projecting through a slot in the hub can beutilized in the instrument 1360 to set the instrument in an extendedposition by moving the retracting mechanism distally such thatretraction plate 1394 is moved distally to be locked against lockingmember 1422. As shown in FIG. 38, an end cap 1406 and push member 1471are provided on the instrument 1360, the push member being in the natureof a spring arm mounted in end cap 1406 and having a bent end forengaging the retraction plate with a protrusion 1428, the push memberbeing similar to the locking and releasing mechanisms previouslydescribed for use as push members. The valve assembly for instrument1360 includes a one-piece, hollow cylindrical, truncated conical ortubular valve body 1438 having a peripheral flange for mounting in arear end of housing 1368. Valve body 1438 is made from flexible,stretchable, elastic or resilient material, such as silicone or rubber,and is provided with one or more than one slit 1455 extendinglongitudinally therealong allowing instrument of various sizes to beinserted through the lumen of the valve body with the valve bodyconforming to the size of the instruments to produce a seal therewith.

Operation of automatic retractable safety penetrating instrument 1360 issimilar to that previously described in that the instrument is moved tothe extended position via squeezing operation of retracing mechanismdistally to the extended position illustrated in FIG. 38. In theextended position, the junction 1384 of the penetrating member 1362 isdisposed beyond the distal end of the portal sleeve 1364, operatingmember 1388 is in the initial position abutting engagement wall 1351 tobe disposed distally of trigger member 1426, trigger member 1426 isdisposed in the path of longitudinal movement of the ear 1315 andretraction plate 1394 is locked in place against locking member 1422. Inorder to facilitate movement of the retraction plate 1394 distally pastthe locking member when setting the instrument in the extended position,a forward edge 1457 of the retraction plate can be angled as shown inFIG. 41. With the instrument in the extended position, locking member1422 will engage the retraction plate 1394 just inwardly of the forwardedge 1457 as best illustrated in FIG. 41. Once the retraction plate islocked in place against the locking member 1422, further squeezing ofthe end cap 1406 causes the angled distal portion of protrusion 1428 tobe engaged by the hub rear wall causing the push member 1471 to bepivoted in a direction outwardly form a longitudinal axis of theinstrument such that the bent end is disengaged from the retractionplate. The push member will be moved out of the path of movement of theretraction plate with protrusion 1428 locking the end cap relative tothe hub. When instrument 1360 is utilized to penetrate tissue,penetrating member 1362 will be moved proximally causing proximalmovement of operating flange 1388 and with it ear 1315 to a set positionsuch that junction 1384 is substantially aligned with the distal end ofthe portal sleeve in an operative position for the instrument, andcompression of the operating spring can serve as a positive stoplimiting proximal movement of the penetrating member. Ear 1315 movesproximally by trigger member 1326 causing arm 1418 to pivot around thepivot axis, i.e. over the trigger member as illustrated in FIG. 42,inwardly toward a longitudinal axis of the instrument with the pivotaxis being parallel with the instrument axis. Accordingly, lockingmember 1422 will move inwardly along the retraction plate 1394 furtherfrom the edge 1457 as shown by the arrow in FIG. 42 such that theretraction plate 1394 remains locked in place. Once the distal end ofthe portal sleeve has entered the anatomical cavity, penetrating member1362 will be moved distally causing distal movement of the operatingmember 1388 toward the initial position with ear 1315 moving distally,i.e. under the trigger member 1426 as shown in dotted lines in FIG. 43,causing arm 1418 to pivot around the pivot axis in a direction outwardlyfrom the instrument axis and toward base 1416 such that the lockingmember 1422 is moved outwardly of the edge 1457 as shown by the arrow inFIG. 43 thusly releasing the retraction plate 1394. Accordingly,retracting spring 1402 will move the retraction member and with it thepenetrating member to the retracted position. It will be appreciatedthat the locking member 1422 can have various structural configurationsto prevent proximal movement of the retracting mechanism and to releasethe retraction member in response to pivoting of the latch around anaxis parallel with the instrument axis. Trigger member 1426 can havevarious configurations to allow proximal movement of the operatingmember thereby without releasing the retraction plate and to causepivoting of arm 1418 around the pivot axis in response to distalmovement of the operating member toward the initial position. Theoperating member 1388 can have various configurations with or withoutear 1315 to move proximally by the trigger member 1426 without causingdisengagement of locking member 1422 from retraction plate 1394 to pivotarm 1418 to release the retraction plate in response to distal movementof the operating member toward the initial position. While one lockingand releasing mechanism 1412 is provided in the instrument 1360, morethan one locking and releasing mechanism can be provided. The lockingand releasing mechanism 1412 can be made in many various ways includinga length of wire bent in a desired configuration to form the locking andtrigger members and an elongated strip or bar with the trigger andlocking members thereon. The locking and releasing mechanism can be madeof a spring material to produce the desired pivotal or flexing movementor the locking and releasing mechanism can be pivotably or rotatablymounted in the instrument and biased to the normal position. Dependingupon its configuration, the locking and releasing mechanism can bepivotally mounted in many ways; and, where the locking and releasingmechanism is made from a wire or strip of material, one or both ends ofthe wire or strip can be pivotally secured in the instrument to mountthe locking and releasing mechanism for pivotal movement around an axisparallel with the longitudinal axis of the instrument with a torsionalbias biasing the locking and releasing mechanism to the normal position.

Another modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated at 1460 inFIG. 44, the instrument 1460 being similar to the instrument 1360 exceptthat the retraction member for instrument 1460 includes only theretraction plate 1494 with the locking member 1522 disposed distally ofthe trigger member 1526 to lock the retraction plate against a frontwall of the hub 1466 in the extended position for the instrument.

In use, instrument 1460 is forced through tissue causing proximalmovement of operating member 1488 by trigger member 1526 to the setposition to produce pivotal movement of the locking and releasingmechanism 1512 without disengaging locking member 1522 from retractionplate 1494. Upon a distal end of the portal sleeve entering theanatomical cavity, the operating member 1488 will be moved distallytoward the initial position to engage trigger member 1526 and pivot thelocking and releasing mechanism 1512 around an axis parallel with alongitudinal axis of the instrument in a direction outwardly from thelongitudinal axis such that the retraction plate is released forretraction by retracting spring 1502. By forming the locking member as aretraction plate only and by positioning the locking member distally ofand close to the trigger member, the space required for the locking andreleasing mechanism can be reduced allowing the length of the hub 1466to be minimized.

A still further modification of an automatic retractable safetypenetrating instrument according to the present invention is illustratedin FIG. 45 at 1560. Automatic retractable safety penetrating instrument1560 is similar to automatic retractable safety penetrating instrument1460; however, a safety shield 1563 is utilized in instrument 1560 totrigger retraction, the safety shield terminating proximally at anoperating member 1588. The locking and releasing mechanism 1612 forinstrument 1560 is similar to locking and releasing mechanism 1512;however, the operating member 1588 for automatic retractable safetypenetrating instrument 1560 is positioned by an operating spring 1598and a cushion spring 1600 in an initial position disposed proximally ofa trigger member 1624 with the instrument in the extended positionillustrated in FIG. 45. The penetrating member 1562 terminatesproximally at retraction plate 1594 with the operating spring connectedbetween the retraction plate and the operating member and the cushionspring connected between the operating member and the front wall of hub1566. Instead of a spring, the retracting mechanism for instrument 1560includes a magnetic bias with magnets 1669 being mounted in a rear wallof the hub 1566 and the retraction plate 1594 being made of amagnetizable material. Where use of magnets 1659 in the hub rear wall isnot desired, the rear wall of the hub can be made of a material havingone polarity with the retraction plate being made of a material havingthe opposite polarity. End cap 1606 is movably mounted relative to hub1566 by bias members including mounting springs 1610 secured between arear wall of the end cap and attachment blocks 1661 secured to anddisposed in hub 1566. A push member 1671 is mounted in end cap 1600 forsetting the instrument is the extended position, the push member 1671being similar to push member 1471. An end cap release mechanism forlocking the end cap relative to the hub and for releasing the end capfrom the hub includes an actuating button 1630 made up of a spring 1631externally secured on skirt 1608 of end cap 1606, the spring 1631 havinga normal condition defining one or more than one bumps or protrusionsfor being received in an opening in a wall of the hub 1566 with theinstrument in an extended position as illustrated in FIG. 45 and forbeing moved to a collapsed or flattened position allowing the end cap tobe released from the hub.

Operation of the automatic retractable safety penetrating instrument1560 is similar to that previously described in that the instrument canbe moved to the extended position by squeezing end cap 1606 causing pushmember 1671, via engagement with the retraction plate 1594, to move thepenetrating member and with it the safety shield distally such that theretraction plate is moved past locking member 1622 to be locked inplace. Continued squeezing of the end cap causes protrusion 1628 toenter the hub such that the push member is flexed in a directionoutwardly from the instrument axis to be disengaged from the retractionplate. Distal movement of the end cap causes spring 1631 to be collapsedor flattened until it is aligned with the opening in the hub at whichtime the push member will be out of the path of movement of theretraction plate 1594 and the operating member 1588. Once aligned withthe opening in the hub, spring 1631 will return to the normal conditionlocking the end cap in place. During penetration of tissue, safetyshield 1563 will be moved proximally such that operating member 1588 ismoved proximally from the initial position to a set position in theoperative position for the instrument. Upon a distal end of the portalsleeve entering the anatomical cavity, the safety shield will be movedistally causing operating member 1588 to be moved distally of theinitial position to engage trigger member 1624 and pivot the locking andreleasing mechanism 1612 around an axis parallel with a longitudinalaxis of the instrument to release the retraction plate 1594.Accordingly, the magnetic bias will move the penetrating member and thesafety shield to the retracted position.

A modification of a locking and releasing mechanism for use with theautomatic retractable safety penetrating instruments according to thepresent invention is illustrated at 1712 in FIG. 46, the locking andreleasing mechanism 1712 being similar to locking and releasingmechanisms 1412, 1512 and 1612 except that locking and releasingmechanism 1712 is made from a length of metal or plastic wire orfilament bent to define a locking member 1722 and a trigger member 1726.Locking and releasing mechanism 1712 has ends formed as or secured tocoil springs 1799 for torsionally biasing the locking and releasingmechanism to a normal position when the ends are secured, such as to thefront and rear walls of the hub of an automatic retractable safetypenetrating instrument.

Yet another modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated in FIG. 47at 1760, only the penetrating unit for the instrument 1760 being shown.Penetrating member 1762 for instrument 1760 is made up of a distal part1770 mounted for telescoping movement relative to a tubular end part1772. Distal part 1770 has a distal end 1776 terminating distally at tip1778 and proximally at a junction 1784 joining the distal end to anelongate outer tubular body 1842. Outer body 1842 is concentricallydisposed around an inner body 1774 extending proximally from an internalend wall or shoulder 1780 disposed in outer body 1842 transverse to alongitudinal axis of the instrument. Inner body 1774 terminatesproximally at an operating member 1788 disposed in end part 1772 withthe inner body passing through an opening in a forward or stop orabutment wall 1792 at a distal end of the end part 1772. The distal endof end part 1772 is disposed in outer body 1842 with the end partterminating proximally at a proximal end joined to or formed as part ofhub 1766. A sheath 1844 is concentrically disposed around the end part1772 at the proximal end thereof, the sheath terminating distally at aforward end spaced from the outer body 1842 by a distance that is equalto the retraction distance for the distal part 1770. Outer body 1842 hasan outer diameter that is the same as the outer diameter of sheath 1844to be received by the inner diameter of the portal sleeve 1764. Aretracting member is disposed in the end part 1772 and includes aU-shaped or rectangular member defining a retraction plate 1794, one ormore connecting or side walls 1853 extending distally from theretraction plate and a forward wall 1851 distally joined to side walls1853 with the forward wall having an opening therein allowing passagetherethrough by the inner body 1774. Inner body 1774 is hollow ortubular or partly hollow or tubular to receive a control tube 1796extending distally from a rear wall of the hub, the control tube passingthrough an opening in the retraction plate 1794. The retracting memberdefines an enclosure or structure for receiving the operating flange1788, an operating spring 1798 concentrically disposed around thecontrol tube and connected between the operating flange 1788 and theretraction plate 1794 to bias the distal part 1770 in a distal directionrelative to the end part 1772 and a cushion spring 1800 concentricallydisposed around the inner body 1774 and connected between the operatingflange 1788 and the forward wall 1851 to bias the distal part in aproximal direction such that the operating flange is maintained at aninitial position with the instrument in the extended position asillustrated in FIG. 47. One ore more than one retracting spring 1802biases the retraction member in a proximai direction. Various differenttypes of springs as well as other types of bias devices can be utilizedin the instrument 1760 to bias the retracting member; and, as shown inFIG. 48, the retracting spring can be a torsion spring. As illustratedin FIG. 48, the retracting spring 1802 is a coil torsion spring that canbe mounted in instrument 1760 with an end of the spring connected to theretraction plate 1794, such that the spring is unwound to bias theretraction member proximally in the extended position as illustrated inFIG. 47 and is rewound to move the retraction member proximally to aretracted position upon release of the retraction plate as will beexplained further below, and the spring is wound and unwound about anaxis transverse to the direction of movement of the penetrating memberbetween the extended and retracted positions. The spring 1802 can bearranged in instrument 1760 in many ways including within or externallyof the penetrating member or within the control tube, the hub or thevalve housing to wind on an axis transverse to the direction ofretraction. Locking and releasing mechanism 1812 for automaticretractable safety penetrating instrument is similar to locking andreleasing mechanism 512 except that the locking and releasing mechanism1812 is mounted within control tube 1796 with trigger members 1824 and1826 extending through a longitudinal slot in the control tube to bedisposed in the path of movement of operating flange 1788, the operatingflange projecting inwardly from an internal surface of the wall of innerbody 1774. Locking member 1822 for locking and releasing mechanism 1812includes a protrusion on arm 1818 proximally spaced from trigger members1826, the locking member having a distal portion disposed transverse toa longitudinal axis of the instrument to prevent proximal movement ofretraction plate 1794 thereby and a proximal portion angled in a distaldirection to permit distal movement of the retraction member therebywhen setting the instrument in the extended position. Various differenttypes of push members can be utilized in the instrument 1760 to move theretracting mechanism distally when setting the instrument in extendedposition; and, as shown in FIG. 47, a pair of push members 1871 in thenature of arms connected between a rear wall of end cap 1806 and theretraction plate 1794 are provided. End cap 1806 has a skirt 1808disposed externally of the hub 1766, and the distance that the end capmust be moved proximally in the ready position will be in accordancewith the distance that the push member must be moved proximally toengage the retracting mechanism for movement to the extended position.

In use, the automatic retractable safety penetrating instrument 1760 canbe moved to the extended position via squeezing operation of end cap1806 causing movement of the retracting member distally unwindingsprings 1802 with the proximal portion of locking member 1822 allowingthe retraction member to move distally thereby until the retractionplate 1794 is locked in place against the distal portion of the lockingmember. With the instrument in the extended position, junction 1784 ofthe penetrating member 1762 will be disposed beyond the distal end ofthe portal sleeve 1764 and the operating member 1788 will be in theinitial position disposed proximally of trigger members 1824 anddistally of trigger members 1826. During penetration of tissue, thedistal part 1770 is moved proximally relative to the end part 1772causing proximal movement of operating member 1788 past trigger members1826 to a set position without causing flexing of the arm 1818, and theinstrument will be in the operative position with junction 1784substantially aligned with the distal end of the portal sleeve. Once thedistal end of the portal sleeve has entered the anatomical cavity, thedistal part 1770 will be moved distally relative to the end part 1772causing operating member 1788 to move distally toward the initialposition to engage a distally closest trigger member 1826 causingflexing of arm 1818 such that locking member 1822 is moved into thecontrol tube thusly releasing the retraction plate 1794. Once theretraction plate is released, springs 1802 are rewound moving theretraction member and with it the distal part 1772 of the penetratingmember in a proximal direction to the retracted position with the tip1778 disposed in the portal sleeve in a safe, protected position.Trigger members 1824 can be utilized to trigger retraction via movementof the operating member 1788 distally of the initial position.

Thus, it will be appreciated that in automatic retractable safetypenetrating instrument 1760 the shaft of the penetrating member isformed of telescoping parts such that the distal end 1776 is retractedby telescoping proximal movement of the distal part of the penetratingmember relative to the end part of the penetrating member whereby hub1766 need not house any mechanism and need not provide any longitudinalspace for retraction of the penetrating member distal end such that thelength of the hub can be minimized. The retracting mechanism retractsthe distal end until shoulder 1780 abuts wall 1792 such that the distalend is within the portal sleeve, and the sliding or telescoping movementbetween the parts of the penetrating member can be accomplished withother structural arrangements, for example, by eliminating outer tubularbody 1842 to permit the distal part to telescope only within the endpart.

FIG. 49 illustrates an alternative arrangement for the retractingmechanism for the automatic retractable safety penetrating instrument1760 wherein the torsion spring 1802 is connected to a flange 1846 of aspool 1848 having an axle for winding thereon of a connector 1850secured between the spool and the retracting member. The connector canbe a length of any suitable material including wire, synthetic plastic,string materials and the like for being in a wound condition on thespool 1848 in response to rotation of the spool by torsion spring 1802.

Yet another modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated in FIG. 50at 1860, only the penetrating unit for the instrument 1860 being shown.Penetrating member 1862 for instrument 1860 is made up of a distal part1870 mounted for telescoping movement within a tubular end part 1872.Distal part 1870 includes a distal end 1876 proximally joined to acylindrical neck 1886 at a junction 1884, the neck 1886 terminatingproximally at a shoulder 1880. A body 1874 having an outer diameter orsize less than the outer diameter of neck 1886 extends proximally fromshoulder 1880 to be disposed within the end part 1872 with the body 1874extending through an opening in a forward or abutment wall 1892 at adistal end of the end part. End part 1872 has an outer diameter that isthe same as the outer diameter of neck 1886 to be received by the innerdiameter of the portal sleeve. Body 1874 terminates proximally at an endwall 1852, and a tubular neck or extension 1954 extends proximally fromthe end wall to terminate at an operating flange 1888 disposed in endpart 1872. A coil torsion operating spring 1898 is connected betweenoperating member 1888 and abutment wall 1892, the spring 1898 beingpartially unwound to bias the distal part 1870 in a distal directionrelative to the end part 1872. A retraction plate 1894 is disposedwithin the end part and has an opening therein allowing passagetherethrough by the neck 1854. A coil torsion retracting spring 1902 isconnected between the retraction plate 1894 and a non-movable part, suchas a wall of end part 1872, of the instrument 1860, the retractingspring being unwound to bias the retraction plate in a proximaldirection to abut the operating flange in the extended position for theinstrument illustrated in FIG. 50. Connecting walls 1953 extend distallyfrom retraction plate 1894 to terminate at a forward wall 1951 servingas a stop or abutment limiting proximal movement of the distal part 1870during penetration of tissue. Locking and releasing mechanism 1912 forinstrument 1860 is similar to the locking and releasing mechanism 112except that two locking springs are provided in the instrument 1860having triggers 1926 disposed proximally of the operating member 1888 inthe initial position illustrated in FIG. 50. The locking springs forinstrument 1860 can be utilized as push members or the locking springscan be utilized only for locking and releasing the retracting mechanismwith separate push members provided for moving the instrument to theextended position.

Operation of the automatic retractable safety penetrating instrument1860 is similar to that previously described in that the distal part1870 of the penetrating member 1862 will be moved proximally relative tothe end part 1872 during penetration of tissue causing proximal movementof operating member 1888 from the initial position past triggers 1926 tothe set position at which time the instrument will be in the operativeposition with junction 1884 substantially aligned with the distal end ofportal sleeve 1864. Movement of the operating member proximally causesoperating spring 1898 to be further unwound with the forward wall 1951serving as a positive stop limiting proximal movement of the distalpart. Once the distal end of the portal sleeve has entered theanatomical cavity, operating spring 1898 will rewind causing the distalpart 1870 to be moved distally relative to the end part 1872 such thatthe operating flange 1888 engages the distally closest triggers 1926 toflex the arms 1918 in a direction outwardly from a longitudinal axis ofthe instrument such that the retracting plate 1894 is released from thelocking members 1922. Accordingly, retracting spring 1902 will rewindcausing telescoping proximal movement of the distal part 1870 relativeto the end part 1872 such that the distal end 1876 of the penetratingmember 1862 is moved to a retracted position within the portal sleevewith abutment 1892 limiting retraction of the distal part.

A further modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated in FIG. 51at 1960. Automatic retractable safety penetrating instrument 1960 issimilar to instrument 1760 except that the penetrating member 1962 forinstrument 1960 does not have an outer body and the locking andreleasing mechanism 2012 for instrument 1960 includes a latch that issimilar to the latch for instrument 1360. The penetrating member 1962for automatic retractable safety penetrating instrument 1960 includes adistal part 1970 mounted for telescoping movement relative to a tubularend part 1972. Distal part 1970 has a distal end 1976 terminatingdistally at tip 1978 and proximally at a junction 1984 joining thedistal end to a cylindrical neck 1986 terminating proximally at an endwall or shoulder 1980. An elongate body 1974 extends proximally fromshoulder 1980 to terminate at an operating member 1988 disposed in endpart 1972, the neck 1986 having an outer diameter that is the same asthe outer diameter of end part 1972. Body 1974 can be hollow or tubularor partly hollow or tubular as illustrated in FIG. 51 to receive anextension 1997 extending distally from retraction plate 1994 of aretraction member. A connecting wall 2053 extends distally from theretraction plate to terminate at a forward wall 2051 with the operatingmember 1988 being disposed between the forward wall and the retractionplate. The retraction member defines a structure for mounting theoperating member 1988, an operating spring 1998 disposed around theextension 1967 and connected between the operating member and theretraction plate 1994 and a cushion spring 2000 disposed around body1974 and connected between the operating member 1988 and the forwardwall 2051 to position the operating member in an initial position withthe instrument in the extended position as illustrated in FIG. 51. Thelatch or locking spring for locking and releasing mechanism 2012includes a locking member 2022 engaged with retraction plate 1994 toprevent proximal movement thereof and a trigger member 2024 disposeddistally of the operating member 1988 in the initial position. A coiltorsion retracting spring 2002 connected with the retraction member isprovided in the instrument 1960 to bias the retraction plate 1994 in aproximal direction. A push member 1971 can be provided for setting theinstrument in the extended position.

Operation of automatic retractable safety penetrating instrument 1960 issimilar to that described for instrument 1760 in that the distal part1970 is moved proximally relative to the end part 1972 duringpenetration of tissue causing proximal movement of the operating member1988 from the initial position to a set position at which time theinstrument will be in an operative position with junction 1984substantially aligned with the distal end of portal sleeve 1964. Once adistal end of the portal sleeve has entered the anatomical cavity, thedistal part 1970 will be moved distally relative to the end part 1972causing movement of operating member 1988 distally of the initialposition to engage trigger 2024 such that the locking and releasingmechanism 2012 pivots around an axis parallel with a longitudinal axisof the instrument 1960 to release retraction plate 1994 from lockingmember 2022.

Another modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated in FIG. 52at 2060, the instrument 2060 being similar to automatic retractablesafety penetrating instrument 60 except that the end part 2072 ofpenetrating member 2062 does not retract with the distal part 2070, andthe valve assembly for instrument 2060 is different than the valveassembly for instrument 60. End part 2072 for penetrating member 2062terminates distally at a stop or abutment 2092 and proximally at aproximal end secured in or formed with a front wall of hub 2066. Distalpart 2070 includes a cylindrical body 2074 extending proximally fromshoulder 2080 to terminate at an end wall 2152 with a tubular neck 2154extending proximally from end wall 2152 to terminate at operating member2088 disposed in hub 2066. A retraction plate 2094 is disposed in hub2066 and has an opening therein allowing passage therethrough by neck2154. A retracting spring 2102 is connected between the retraction plate2094 and a rear wall of hub 2066 to bias the retraction plate in aproximal direction. A locking and releasing mechanism 2112 is disposedin hub 2066, the locking and releasing mechanism 2112 being similar tothe locking and releasing mechanism 112 for automatic retractable safetypenetrating instrument 60. End wall 2152 is disposed within the end part2072, and an operating spring 2098 is disposed around neck 2154 andconnected between the operating member 2088 and the retraction plate2094 to bias the distal part 2070 in a distal direction. A cushionspring 2100 is disposed concentrically around neck 2154 and connectedbetween the retraction plate 2094 and the end wall 2152 to bias thedistal part in a proximal direction such that operating member 2088 isin an initial position disposed proximally of trigger member 2124 anddistally of trigger members 2126 with the retraction plate 2094 heldagainst the front wall of the hub via locking member 2122 in theextended position for the instrument illustrated in FIG. 52. The valveassembly for instrument 2060 is similar to the valve assembly disclosedin applicant's U.S. patent application Ser. No. 07/557,869, filed Jul.26, 1990, the specification of which is incorporated herein byreference. The valve assembly includes a valve block 2158 having aperipheral flange for being disposed in a recess at a rear end ofhousing 2068 and a cylindrical member extending distally from the flangeto mount a cylindrical or spherical valve body 2138. Valve body 2138 hasa plurality of different size lumens or passages that can be selectivelyaligned with the open proximal end of the portal sleeve 2064 and apassage in the valve block to provide communication through housing2068. The valve assembly includes a spring rotationally biased tomaintain the valve body 2138 in a closed position wherein a solidsurface of the valve body is aligned with the passage in the valve blockto close off and seal the valve housing. An external ridge 2160 isprovided on the valve body for rotating the valve body to an openposition corresponding to one of the lumens being aligned with thepassage. A pin 2117 protrudes distally from the front wall of hub 2066for penetrating through the valve block 2158 and into the valve body2138 when the hub 2066 is combined with the valve housing 2068 asillustrated in FIG. 52.

In operation, the hub 2066 is combined with the valve housing 2068 withpin 2117 penetrating the valve assembly to enter the valve body 2138thusly preventing rotational movement of the valve body toward theclosed position such that strain or friction on penetrating member 2062is eliminated. When the instrument 2060 is forced through tissue, distalpart 2070 will be moved proximally relative to end part 2072 causingproximal movement of operating member 2088 from the initial position toa set position at which time the instrument will be in the operativeposition. Once a distal end of portal sleeve 2064 has entered theanatomical cavity, distal part 2070 will move distally relative to endpart 2072 causing movement of operating member 2088 distally toward theinitial position to engage a trigger 2126 or distally of the initialposition to engage trigger 2124 such that arm 2118 will be flexedreleasing retraction plate 2094 from locking member 2122.

A still further modification of an automatic retractable safetypenetrating instrument according to the present invention is illustratedin FIG. 53 at 2160, wherein only the penetrating unit for instrument2160 is shown. Penetrating member 2162 for instrument 2160 includes adistal end 2176 joined to an elongate tubular or partly tubular body2174 terminating proximally at an operating flange 2188 disposed in hub2166. A control tube 2196 extends distally from a rear wall of end cap2206 and into body 2174, the operating flange 2188 extending inwardlyfrom an internal surface of the wall of the body to be disposed in alongitudinal slot 2191 in the control tube. A retraction plate 2194 isdisposed in hub 2166, the retraction plate extending inwardly through ahole in body 2174 to be disposed in the slot 2191. Operating spring 2198is disposed concentrically around the control tube and connected betweena rear wall of hub 2166 and the operating flange 2188, and a cushionspring 2200 is disposed concentrically around body 2174 and connectedbetween the operating flange 2188 and the retraction plate 2194 toposition the operating flange in an initial position with the instrumentin the extended position illustrated in FIG. 53. The locking andreleasing mechanism 2212 for instrument 2160 is disposed within controltube 2196 and includes a latch or locking spring having an arm 2218formed with a protrusion 2228 for locking the end cap 2206 within thehub 2166 in the extended position for the instrument, a locking member2222 for holding the retraction plate 2194 against a front wall of hub2166 and triggers 2224 and 2226. A stop or abutment in the nature of anadditional bump or protrusion 2192 formed on arm 2218 serves as apositive stop limiting proximal movement of operating member 2188 duringpenetration of tissue. Actuating buttons 2230 for instrument 2160 aremade up of casings or housings mounted in openings in skirt 2208 withhelical springs 2231 disposed in the casings concentrically aroundrelease arms 2232 biasing the casings in a direction outwardly from alongitudinal axis of the instrument and allowing the casings to be movedinwardly toward the instrument axis to compress bend 2116. Althoughillustrated in FIG. 53 as extending through skirt 2208 adjacent a rearwall of the end cap, the buttons 2230 can be mounted at any suitablelocation in accordance with the location for the locking and releasingmechanism. A valve can be provided along the rear wall of end cap 2206in communication with the lumen of the control tube 2196 to providefluid flow through the instrument.

Automatic retractable safety penetrating instrument 2160 can be utilizedto penetrate tissue and enter an anatomical cavity as previouslydescribed with the penetrating member moving proximally duringpenetration of tissue causing proximal movement of operating flange 2188from the initial position to a set position at which time the instrument2160 will be in an operative position. Upon the portal sleeve distal endentering the anatomical cavity, the penetrating member 2162 will bemoved distally causing operating flange 2188 to move toward the initialposition to engage trigger 2226 or distally of the initial position toengage trigger 2224 causing arm 2218 to move within control tube 2196releasing locking member 2222 from retraction plate 2194 whileprotrusion 2228 remains engaged with the rear wall of the hub.Accordingly, retracting spring 2202 will move the retracting member 2194and with it the penetrating member to a retracted position.

A still further modification of an automatic retractable safetypenetrating instrument according to the present invention is illustratedin FIG. 54 at 2260. Penetrating member 2262 for automatic retractablesafety penetrating instrument 2260 is similar to penetrating member 1962for automatic retractable safety penetrating instrument 1960 andincludes an elongate body 2274 joined to neck 2286 at shoulder 2280, thebody 2274 terminating proximally at a retraction plate 2294 disposed inend part 2272. Body 2274 can be removably secured to neck 2286 such asby threads 2290 allowing distal end 2276 to be removed from body 2274and replaced with various other distal ends of diverse configurations. Asafety shield 2263 is disposed around the penetrating member 2262 andincludes an outer body concentrically disposed around the neck 2286 andend part 2272 of the penetrating member and an inner tubular body 2274'joined to the outer tubular body at an internal shoulder or end wall2280'. Inner body 2274' is concentrically disposed around body 2274 andterminates proximally at an operating member 2288 disposed in end part2272 distally of retraction plate 2294 with body 2274' passing throughan opening in a forward wall of the end part. A locking and releasingmechanism 2318 is mounted in end part 2272, the locking and releasingmechanism 2318 being similar to the locking and releasing mechanism1812. A control tube 2296 extends from a rear wall of end cap 2306 andinto body 2274, and a retracting spring 2302 is connected betweenretraction plate 2294 and a rear wall of hub 2266 to bias the distalpart 2270 of the penetrating member in a proximal direction. Controltube 2296 can be rotatably, releasably mounted in end cap 2306 to bepartially withdrawn from body 2274 with ears, nubs or projectionsprovided on the control tube to allow the control tube to serve as apush member for setting the instrument in the extended position asdisclosed in applicant's co-pending U.S. patent application Ser. No.07/868,578 filed Apr. 15, 1992, the specification of which isincorporated herein by reference. An operating spring 2298 is disposedconcentrically around body 2274 and connected between retraction plate2294 and operating member 2288, and a cushion spring 2300 isconcentrically disposed around body 2274' and connected betweenoperating flange 2272 and the forward wall of end part 2278 to positionthe operating flange at an initial position in the extended position forthe instrument illustrated in FIG. 54. In the extended position,operating flange 2288 will be in the initial position disposedproximally of triggers 2324 and distally of triggers 2326, and theretraction plate 2294 will be locked in place against locking member2322.

Operation of automatic retractable safety penetrating instrument 2260 issimilar to that previously described in that safety shield 2263 willmove proximally during penetration of tissue causing movement ofoperating flange 2288 from the initial position to a set position atwhich time the instrument will be in an operative position. Once adistal end of the portal sleeve has entered the anatomical cavity, thesafety shield will be moved distally causing movement of operatingflange 2288 toward the initial position to engage a trigger 2326 ordistally of the initial position to engage a trigger 2324 such that arm2318 is flexed releasing retraction plate 2294 from locking member 2322.Accordingly, retracting spring 2302 will move the distal part 2270 ofthe penetrating member and, via engagement of shoulder 2280 with endwall 2280', the safety shield, to a retracted position. A probe can beutilized in the instrument 2260 in place of the safety shield to triggerretraction as shown in dotted lines at 2265. By utilizing a pin and slotarrangement, retraction of the distal part of the penetrating memberand/or the safety shield and the probe where a probe is-provided can beprevented.

Another modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated in FIG. 55at 2360, the instrument 2360 being similar to automatic retractablesafety penetrating instrument 2260 in that a safety shield 2363 isutilized to trigger retraction. Penetrating member 2362 for instrument2360 is made up of a distal part 2370 and an end part 2372, the distalpart including a distal end 2376 joined to an elongate body 2374 with anextension 2454 in the form of a plate extending proximally from an endwall 2452 of body 2374. Extension 2454 terminates proximally within thebody of safety shield 2363 at a bent end defining a retraction member orincluding retraction plate 2394. End part 2372 includes a plateextending distally from a rear wall of hub 2366 and terminating distallyat a bent or angled end with a retracting spring 2402 connected betweenthe angled end of end part 2372 and the end wall 2452 of distal part2370 to bias the distal part in a proximal direction. A locking andreleasing mechanism 2412 similar to locking and releasing mechanism 2112is disposed partly in hub 2366 and partly in the body of safety shield2363 with a base 2416 of the locking and releasing mechanism beingsecured to end part 2372. A locking member 2422 of locking and releasingmechanism 2412 engages retraction plate 2394 to prevent proximalmovement of the distal part 2370 when the instrument is in the extendedposition illustrated in FIG. 55. Safety shield 2363 is concentricallydisposed around body 2374, the safety shield terminating proximally atan end flange disposed in hub 2366 with the body of the safety shieldpassing through an opening in a front wall of the hub. An operatingmember or flange 2388 projects inwardly from an inner surface of thewall of the safety shield body for engaging triggers 2424 or 2426 on arm2418 of locking and releasing mechanism 2412. An operating spring 2398is connected between the end flange and a rear wall of the hub, and acushion spring 2400 is connected between the end flange and a front wallof the hub to position the operating member at an initial positionproximally of triggers 2424 and distally of triggers 2426 in theextended position for the instrument. A push member 2371 can be providedin instrument 2360 to be moved by end cap 2406 to engage the end flangeof the safety shield for use in setting the instrument in the extendedposition.

In operation, instrument 2360 is forced through tissue causing safetyshield 2363 to be moved proximally such that operating member 2388 ismoved proximally from the initial position to a set position withoutcausing bending or flexing of arm 2418. Once a distal end of the portalsleeve has entered the anatomical cavity, the safety shield 2363 will bemoved distally causing operating member 2388 to engage a trigger 2426 inresponse to movement of the operating member toward the initial positionor a trigger 2424 in response to movement of the operating memberdistally of the initial position to flex arm 2418 and release lockingmember 2422 from retraction plate 2394. Accordingly, retracting spring2402 will move the distal part 2370 of the penetrating member proximallyrelative to the end part 2372 to a retracted position. By arranging theoperating member 2388 to be engaged by the retraction plate 2394, thesafety shield 2363 can be moved to a retracted position with thepenetrating member. Push member 2371 can be utilized to set theinstrument in the extended position via squeezing operation of end cap2406 causing distal movement of the safety shield and, via engagement ofoperating member 2388 with retraction plate 2394, the penetratingmember.

Yet another modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated at 2460 inFIG. 56. Penetrating member 2462 for automatic retractable safetypenetrating instrument 2460 is similar to penetrating member 1862 beingmade up of a distal part 2470 and an end part 2472 with the distal partincluding a distal end 2476, a body 2474 and a neck 2554. End part 2472terminates proximally at a retraction plate 2494 disposed in hub 2466,and a retraction spring 2502 is connected between the retraction plateand the rear wall of the hub to bias the end part in a proximaldirection. A locking and releasing mechanism 2512 similar to locking andreleasing mechanism 1912 is disposed in hub 2466 for locking theretraction plate 2494 against a front wall of the hub in an extendedposition for the instrument illustrated in FIG. 56. Locking andreleasing mechanism 2512 is mounted in end cap 2506 to serve as a pushmember for setting the instrument in an extended position, and anadditional push member 2471 can be mounted in end cap 2506 for use inmoving the end part 2472 distally when setting the instrument in theextended position. A plurality of internal walls or shoulders 2552' aredisposed within end part 2472 with the walls 2552 having openingstherein allowing passage therethrough by the neck 2554. Neck 2554terminates proximally at an operating member or flange 2488 disposed inhub 2466. A helical coil operating spring 2498 is concentricallydisposed around neck 2554 and connected between the neck and a wall2552' of the end part to bias the distal part 2470 in a distaldirection. More than one operating spring can be provided; and, as shownin FIG. 56, two operating springs 1498 are provided with each operatingspring connected between the neck 2554 and an internal wall 2252'. Acushion spring 2500 is disposed concentrically around the neck 2554 andconnected between body 2474 and a wall 2552' to bias the distal part ina proximal direction such that operating flange 2488 is maintained in aninitial position disposed proximally of trigger 2524 and distally oftriggers 2526 with the instrument in the extended position. Protrusionsin the form of nubs or pins 2545' are provided on neck 2554 for use inmounting the operating and cushion springs between the neck 2554 and theinternal walls 2552' and for compressing or collapsing the springs uponmovement of the distal part in a proximai direction.

In use, the automatic retractable safety penetrating instrument 2460 isforced through tissue causing distal part 2470 to be moved proximallyrelative to end part 2472 such that operating member 2488 is movedproximally of the initial position to a set position, the nubs 2545'collapsing the operating and cushion springs along the neck 2554. Withthe operating member in the set position, shoulder 2480 will be inabutment with stop 2492, and the instrument will be in an operativeposition. Once a distal end of the portal sleeve 2464 has entered theanatomical cavity, the distal part 2470 will be moved distally causingoperating member 2488 to move toward the initial position to engagetrigger 2526 or distally of the initial position to engage trigger 2524and flex arm 2518 thusly releasing the retraction plate 2494.

An additional modification of an automatic retractable safetypenetrating instrument is illustrated in FIG. 57 at 2560. Instrument2560 is similar to automatic retractable safety penetrating instrument2460 except that neck 2654 for automatic retractable safety penetratinginstrument 2560 is offset from and not aligned with a longitudinal axisof the instrument as is neck 2554 for instrument 2460. The retractionmember for instrument 2560 is formed as an internal wall or shoulder2652' extending inwardly from an inner surface of the wall of the endpart 2572 to be engaged, within the end part, by locking member 2622,the retraction member having an opening therein allowing passagetherethrough by the neck 2654. End part 2572 terminates proximally at aretraction plate or flange disposed in hub 2566 with retracting springs2602 connected between the retraction plate and a rear wall of the hubto bias the end part in a proximal direction. Accordingly, in theautomatic retractable safety penetrating instrument 2560, the lockingmember 2622 engages the retraction member, wall 2652', and not theretraction plate 2594 to hold the end part 2572 against proximalmovement. Locking and releasing mechanism 2612 for automatic retractablesafety penetrating instrument 2560 is mounted in end cap 2606 for use asa push member, via engagement of locking member 2622 with wall 2652',for setting the instrument in an extended position. An additional pushmember 2571 is mounted in end cap 2606 for engaging retraction plate2594 when setting the instrument in the extended position via squeezingoperation of the end cap. In the automatic retractable safetypenetrating instrument 2560, triggers 2624 and 2626 are disposed withinthe end part 2572 such that the length of hub 2566 can be minimized tobe no larger than necessary to allow retraction of end part 2572. Neck2654 terminates proximally at an operating member or flange 2588disposed in end part 2572 with the operating member having an angled endto facilitate proximal movement past triggers 2626 and engagement oftriggers 2624 or 2626 upon distal movement of the operating member. Anadditional internal wall 2652" is provided in end part 2572, with anoperating spring 2598 disposed around neck 2654 and connected betweenthe internal wall 2652" and the body 2574 to bias the distal part 2570distally. A cushion spring 2600 disposed around neck 2654 is connectedbetween the neck 2654 and wall 2652' to bias the distal part proximallysuch that the operating member is maintained at an initial positionproximally of triggers 2624 and distally of triggers 2626 in theextended position illustrated in FIG. 57.

Operation of instrument 2560 is similar to that for automaticretractable safety penetrating instrument 2460. During penetration oftissue, distal part 2570 moves proximally relative to end part 2572causing proximal movement of operating member 2588 past triggers 2626.Once a distal end of portal sleeve 2564 has entered the anatomicalcavity, operating member 2588 will move distally engaging triggers 2624or 2626 to flex arm 2618 and release the retraction member, wall 2652'.Accordingly, retracting springs 2602 move the end part 2572 and with itdistal part 2570 to the retracted position.

Yet another modification of an automatic retractable safety penetratinginstrument according to the present invention is illustrated at 2660 inFIG. 58. Penetrating member 2662 for automatic retractable safetypenetrating instrument 2660 is similar to penetrating member 1862 andincludes an end part 2672 and a distal part 2670 having a distal end2676, a tubular or partly hollow or tubular body 2674 and a neck 2754. Aretraction member engages the proximal end of distal part 2670 andincludes a retraction plate 2694 disposed in hub 2664 with an extension2697 extending distally from the retraction plate to terminate at aforward wall or end flange 2751 disposed in body 2674 with the extension2697 being concentrically disposed in neck 2654. Neck 2654 terminatesproximally at an operating member or flange 2688 disposed in end part2672, and an operating spring 2698 is disposed concentrically aroundextension 2697 and connected between operating member 2688 andretraction plate 2694 to bias the distal part 2670 in a distaldirection. A cushion spring 2700 is concentrically disposed around theextension 2697 and connected between the forward wall 2751 and an endwall 2752 of body 2674 to bias the distal part in a proximal directionsuch that operating member 2688 is maintained in an initial positionwith the instrument in the extended position as illustrated in FIG. 58.A retracting spring 2702 is disposed in hub 2664 and connected betweenthe retraction plate 2694 and a rear wall of the hub to bias theretraction member in a proximal direction. Locking and releasingmechanism 2712 for automatic retractable safety penetrating instrument2660 is made up of a linkage arrangement including a link arm 2718having an end pivotally connected at a joint to a trigger 2724 includinga trigger cam 2727 and a trigger leg 2729 and an opposite end pivotallyconnected at a joint to a link 2723' pivotally mounted in hub 2664. Link2723' is disposed in engagement with the retraction plate in theextended position for the instrument illustrated in FIG. 58 and ismounted on a joint in hub 2664 to rotate, such as in a counterclockwisedirection looking at FIG. 58, to be disposed out of the path oflongitudinal movement of retraction plate 2694 in response to proximalmovement of link arm 2718. A locking arm 2718' is pivotally mounted inthe hub, such as along the hub rear wall, and is biased to a lockedposition wherein an end or finger 2822 of the locking arm engages alateral or upper edge or side of the retraction plate 2694 to preventproximal movement thereof. The locking arm 2718' can be biased to thelocked position in various ways, such as by a spring at the jointmounting the arm 2718' along the hub rear wall. With the arm 2718' inthe locked position, locking member 2822 will be disposed in the path ofmovement of link arm 2718. The linkage can be biased, such as withsprings provided at one or more joints of the linkage, to rotate link2723' to release retraction plate 2694 with arm 2718' preventingmovement of the linkage due to the bias. Where the arm 2718' bothengages the retraction plate and holds link 2723' thereagainst,redundant protection is provided.

Operation of automatic retractable safety penetrating instrument 2660 issimilar to that previously described in that the distal part 2670 willbe moved proximally relative to end part 2672 during penetration oftissue causing operating member 2688 to be moved proximally from theinitial position to the set position. Once a distal end of the portalsleeve has entered the anatomical cavity, distal part 2670 will be moveddistally relative to end part 2772 causing operating member 2688 to movedistally of the initial position to engage trigger cam 2727 and pivottrigger leg 2729 clockwise looking at FIG. 58 moving link arm 2718proximally to engage a nub 2710' on locking member 2822 such that thelocking arm 2718' is moved laterally, i.e. in a direction transverse tothe direction of proximai movement of link arm 2718 to be released fromretraction plate 2694 allowing the distal part 2670 of the penetratingmember to be moved relative to the end part 2672 to a retractedposition.

An additional modification of an automatic retractable safetypenetrating instrument according to the present invention is illustratedin FIG. 59 at 2760. Penetrating member 2762 for automatic retractablesafety penetrating instrument 2760 is similar to penetrating member 2362except that body 2774 for penetrating member 2762 is hollow or tubularor partly hollow or tubular to receive the forward wall 2851 of theretraction member and the end part 2772 of the penetrating member issecured in or formed with a front wall of hub 2766. The retractionmember for instrument 2760 includes forward wall 2851, retraction plate2794 disposed in hub 2766 and a side or connecting member 2853 joiningthe retraction plate to the forward wall with neck 2854 of distal part2770 extending through the connecting member to terminate proximally atan operating flange 2788 disposed in end part 2772. An operating spring2798 is connected between the forward wall 2851 and an end wall 2852 ofbody 2774 to bias the distal part in a distal direction, and a cushionspring 2800 is disposed around neck 2854 and connected between forwardwall 2851 and an internal shoulder or abutment 2780 of body 2774 to biasthe distal part in a proximal direction such that operating member 2788is maintained in an initial position proximally of trigger 2824 with theinstrument in the extended position illustrated in FIG. 59. A retractingspring 2802 is connected between retraction plate 2794 and a rear wallof hub 2766 to bias the retraction member in a proximal direction. Alocking and releasing mechanism 2812 is disposed in end part 2772 andincludes a linkage arrangement having a link arm 2818 pivotallyconnected at a joint at one end to a locking member 2822 engaged with abent or angled portion of connecting wall 2853 to prevent movement ofthe retracting mechanism proximally. Arm 2818 is pivotally connected ata joint at an opposite end thereof to trigger 2824 pivotally mounted inthe end part and including a trigger cam 2827 and a trigger leg 2829. Alocking arm 2818' pivotally mounted at a joint along the rear wall ofhub 2766 terminates distally at a locking member 2822' biased to engagethe linkage to prevent proximal movement of link arm 2818 such that thelocking member 2822 is maintained in engagement with the retractionmember in the extended position for the instrument. The linkage can bebiased to rotate locking member 2822 counterclockwise looking at FIG. 59to release the retraction member with arm 2818' preventing movement ofthe linkage due to the bias.

When automatic retractable safety penetrating instrument 2760 isutilized to penetrate tissue and enter an anatomical cavity, distal part2770 of penetrating member 2762 will be moved proximally duringpenetration of the tissue causing movement of operating member 2788 fromthe initial position to a set position. The distal part 2770 will bemoved distally upon a distal end of the portal sleeve entering theanatomical cavity, and the operating member 2788 will be moved distallyof the initial position to engage trigger cam 2827 causing rotation oftrigger 2824 clockwise and movement of link arm 2818 proximally toengage nub 2810' moving locking arm 2818' in a direction transverse tothe direction of proximal movement of arm 2818 such that the lockingmember 2822 is released from the retraction member. Accordingly,retracting spring 2802 will move the retraction member proximallycarrying with it the distal part 2770 of the penetrating member to aretracted position.

An additional modification of an automatic retractable safetypenetrating instrument according to the present invention is illustratedin FIG. 60 at 2860 wherein an operating spring and the retractingmechanism for instrument 2860 are in the nature of a linkagearrangement. Penetrating member 2862 for automatic retractable safetypenetrating instrument 2860 includes a distal part 2870 terminatingproximally at an operating member or flange 2888 disposed in hub 2866and an end part 287 terminating proximally at a retraction plate 2894disposed in hub 2866. A linkage 2898 including a pair of first links orarms 2898' and 2898" pivotally connected to each other at a centraljoint is pivotally connected to the operating member or flange and theretraction plate at distal and proximal end joints. An operating springmounted at the central joint rotationally biases the links 2898' and2989" to a normal expanded position wherein the operating member 2888 ismaintained in an initial position and the junction of the distal part2870 is disposed beyond the distal end of the portal sleeve by adistance equal to the spacing between shoulder 2880 and abutment 2892 inthe extended position illustrated in FIG. 60. A cross link 2900' ispivotally connected to linkage 2898 at retraction plate 2894 and to alinkage 2902. Linkage 2902 is made up of a plurality of second links orarms including a distal link 2902' pivotally connected at a joint tocross link 2900', a proximal link 2902" pivotally secured to a rear wallof the hub and a cross link 2902" pivotally connected to the distal andproximal links at joints. Linkage 2902 is biased, such as withretracting springs at one or more joints of the linkage, to a collapsedcondition or configuration with cross link 2900' moving end part 2872proximally. A locking and releasing mechanism 2912 is disposed in hub2866 and includes an arm 2918 having a plurality of teeth or barbs 2921thereon for engaging distal link 2902' to lock the linkage 2902 in anexpanded, non-collapsed position in the extended position for theinstrument illustrated in FIG. 60 and a trigger 2926. Trigger 2926 has atrigger cam 2927 disposed proximally of the operating flange in theinitial position and a bent trigger leg 2929 pivotally mounted in hub2866 at 2929' to be disposed in abutment with retraction plate 2894 withthe instrument in the extended position. Trigger leg 2929 is hinged,pivotal or made flexible at 2929" along a portion of the leg disposedalong arm 2918 allowing a forward portion of the trigger leg to rotate,clockwise looking a FIG. 60, around pivot 2929' and a rearward portionof the trigger leg to rotate, counter-clockwise looking at FIG. 60, inresponse to counterclockwise rotation of trigger cam 2927. A push member2871 is disposed in end cap 2906 for moving the linkage 2902, viaengagement of protrusion 2928 with link 2902', distally to engage teeth2921 when setting the instrument in the extended position.

During operation, automatic retractable safety penetrating instrument2860 is forced through tissue causing proximal movement of distal part2870 such that operating member 2888 is moved proximally by trigger cam2927, as permitted due to movement of links 2898' and 2898" to anexpanded configuration, without causing flexing of arm 2918. Once adistal end of the portal sleeve has entered the anatomical cavity, thedistal part 2870 will be moved distally due to movement of links 2898'and 2898" toward the contracted configuration, causing movement ofoperating member 2888 toward the initial position to engage trigger cam2927 to bend or pivot trigger leg 2929 at 2929" causing trigger leg 2929to rotate around pivot 2929' to be disposed out of the path of movementof retraction plate 2894 and arm 2918 to be flexed in a directionoutwardly from a longitudinal axis of the instrument such that link2902' is released from the barbs causing the linkage 2902 to move to acollapsed or contracted position or configuration carrying end part 2872and with it distal part 2870 to a retracted position.

Inasmuch as the present invention is subject to many variations,modifications and changes in detail, it is intended that all subjectmatter discussed above or shown in the accompanying drawings beinterpreted as illustrative only and not be taken in a limiting sense.

What is claimed is:
 1. An automatic retractable safety penetratinginstrument for introducing a sleeve into a cavity in the bodycomprisinga sleeve for providing a passage through a cavity wall andhaving a distal end for positioning in the body cavity, a proximal endfor positioning externally of the body cavity and a lumen extendingbetween said distal and proximal ends; a penetrating member disposed insaid lumen of said sleeve and having a longitudinal axis and a distalend for penetrating the cavity wall; retracting means for moving saiddistal end of said penetrating member proximally relative to said sleevefrom an extended position where said distal end of said penetratingmember protrudes beyond said distal end of said sleeve to a retractedposition within said sleeve, said retracting means including a pluralityof first arms pivotally connected to one another and coupled with saiddistal end of said penetrating member, said first arms being biasedtoward a contracted configuration and being pivotally movable relativeto one another to an expanded configuration, said first arms being insaid expanded configuration when said distal end of said penetratingmember is in said extended position and being in said contractedconfiguration when said distal end of said penetrating member is in saidretracted position; a locking and releasing mechanism for locking saidfirst arms in said expanded configuration during penetration of thecavity wall and for releasing said first arms for movement to saidcontracted configuration to automatically move said distal end of saidpenetrating member to said retracted position in response to entry ofsaid distal end of said sleeve in the body cavity; and an operatingmechanism including a distally biased operating member movableproximally during penetration of the cavity wall and movable distallyupon entry of said distal end of said sleeve in the cavity toautomatically release said first arms for movement to said contractedconfiguration.
 2. An automatic retractable safety penetrating instrumentfor introducing a sleeve into a cavity in the body comprisinga sleevefor providing a passage through a cavity wall and having a distal endfor positioning in the body cavity, a proximal end for positioningexternally of the body cavity and a lumen extending between said distaland proximal ends; a penetrating member disposed in said lumen of saidsleeve and having a longitudinal axis and a distal end for penetratingthe cavity wall; retracting means for moving said distal end of saidpenetrating member proximally relative to said sleeve from an extendedposition where said distal end of said penetrating member protrudesbeyond said distal end of said sleeve to a retracted position withinsaid sleeve, said retracting means including a plurality of first armspivotally connected to one another and coupled with said distal end ofsaid penetrating member, said first arms being biased toward acontracted configuration and being pivotally movable relative to oneanother to an expanded configuration, said first arms being in saidexpanded configuration when said distal end of said penetrating memberis in said extended position and being in said contracted configurationwhen said distal end of said penetrating member is in said retractedposition, said retracting means including a retracting spring biasingsaid first arms toward said contracted configuration;. a locking andreleasing mechanism for locking said first arms in said expandedconfiguration during penetration of the cavity wall and for releasingsaid first arms for movement to said contracted configuration toautomatically move said distal end of said penetrating member to saidretracted position in response to entry of said distal end of saidsleeve in the body cavity; and an operating mechanism including adistally biased operating member movable proximally during penetrationof the cavity wall and movable distally upon entry of said distal end ofsaid sleeve in the cavity to automatically release said first arms formovement to said contracted configuration.
 3. An automatic retractablesafety penetrating instrument as recited in claim 2 wherein saidoperating mechanism includes an operating spring biasing said secondarms toward an expanded configuration while permitting movement of saidsecond arms to a contracted configuration when said operating member ismoved proximally.
 4. An automatic retractable safety penetratinginstrument for introducing a sleeve into a cavity in the bodycomprisinga sleeve for providing a passage through a cavity wall andhaving a distal end for positioning in the body cavity, a proximal endfor positioning externally of the body cavity and a lumen extendingbetween said distal and proximal ends; a penetrating member disposed insaid lumen of said sleeve and having a longitudinal axis and a distalend for penetrating the cavity wall; retracting means for moving saiddistal end of said penetrating member proximally relative to said sleevefrom an extended position where said distal end of said penetratingmember protrudes beyond said distal end of said sleeve to a retractedposition within said sleeve said retracting means including a pluralityof first arms pivotally connected to one another and coupled with saiddistal end of said penetrating member, said first arms being biasedtoward a contracted configuration and being pivotally movable relativeto one another to an expanded configuration, said first arms being insaid expanded configuration when said distal end of said penetratingmember is in said extended position and being in said contractedconfiguration when said distal end of said penetrating member is in saidretracted position; a locking and releasing mechanism for locking saidfirst arms in said expanded configuration during penetration of thecavity wall and for releasing said first arms for movement to saidcontracted configuration to automatically move said distal end of saidpenetrating member to said retracted position in response to entry ofsaid distal end of said sleeve in the body cavity; and an operatingmechanism including a distally biased operating member movableproximally during penetration of the cavity wall and movable distallyupon entry of said distal end of said sleeve in the cavity toautomatically release said first arms for movement to said contractedconfiguration, said operating mechanism including a plurality of secondarms pivotally connected to one another and coupled with said operatingmember, said second arms biasing said operating member distally whilepermitting said operating member to move proximally during penetrationof the cavity wall.